Age Disorientation in Schizophrenia
- Age-disoriented patients are cognitively more impaired than their age-oriented counterparts.
- Whether the cognitive impairment is present to a greater degree premorbid among these patients, studies have not yet established this, but some data support this.
- Others have reported that rated school performance and grade-level do not distinguish age-disoriented from age-oriented subjects.
- Some have suggested that marked cognitive decline occurs following the first break.
- Harvey et al. reported that age-related decline in mini-mental state examination scores is dramatically greater among age-disoriented schizophrenia patients than age-oriented subjects, consistent with more rapid deterioration.
- Examination of the specific PANSS items revealed that the age-disoriented group was consistently more delusional and more conceptually disorganized and showed increased stereotyped thinking, motor retardation, unusual thought content, disorientation, and poor attention.
- There was no relationship between the proximity of assessment month to birth month and the severity of age disorientation.
- There was no relationship between total mini-mental state examination score and either rote memory on the Miller-Selfridge recall task context memory on the same recall task or the type/token ratio generated from the speech sample.
- Age-disoriented patients have certain more severe psychiatric symptoms, more voluntary motor disturbances, more orofacial involuntary movements, and more severe non-localizing sensory signs.
- Most of the assessed cognitive abilities of the age disoriented (i.e., mini-mental state examination performance, context memory, speech repetitiveness) are more disrupted than those of matched age-oriented schizophrenic control subjects.
- Within the age-disoriented group, there was no relationship between mini-mental state examination total scores and other cognitive features, suggesting that age disorientation is not merely an issue of increased severity.
- More severe motor abnormalities predict poor outcome.
- Studies have associated the emergence of involuntary orofacial movements with more severe cognitive decline among schizophrenic samples, irrespective of age disorientation.
References
- Harvey PD, Lombardi J, Kincaid MM, et al: Cognitive functioning in chronically hospitalized schizophrenic patients: age-related changes and age disorientation as predictor of impairment. Schizophr Res 1995; 17:15–24
- Liddle PF, Crow TJ: Age disorientation in chronic schizophrenia is associated with global intellectual impairment. Br J Psychiatry 1984; 144:193–199
- Burich N, Crow TJ, Johnstone EC, et al: Age disorientation in chronic schizophrenia is not associated with pre-morbid intellectual impairment or past physical treatment. Br J Psychiatry 1988; 152:466–469
- Johnstone EC, Macmillan JF, Frith CD, et al: Further investigation of the predictors of outcome following first schizophrenic episodes. Br J Psychiatry 1990; 157:182–189
- Turner TH: A diagnostic analysis of the casebook of Ticehurst House Asylum, 1845–1890. Psychol Med 1992; 21(suppl):1–70
- Waddington JL, Youssef HA: Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dyskinesia. Psychol Med 1996; 26:681–688
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