Km. Putnam et al., SYMPTOM STABILITY IN GERIATRIC CHRONIC-SCHIZOPHRENIC INPATIENTS - A ONE-YEAR FOLLOW-UP-STUDY, Biological psychiatry, 39(2), 1996, pp. 92-99
The results of previous studies of symptom stability in schizophrenia
suggest that negative symptoms manifest traitlike characteristics whil
e positive symptoms fluctuate over time. Various prospective studies o
f chronic schizophrenic patients have found consistent results, regard
less of the follow-up period yet there is little research addressing s
ymptomatalogy in geriatric schizophrenic patients. Since these patient
s have a very poor outcome and more severe negative symptoms, their sy
mptoms might differ from younger patients. This study examined the cou
rse of symptomatology in 178 geriatric schizophrenic inpatients who we
re assessed twice at a 1-year interval with the Positive and Negative
Syndrome Scale (PANSS). Intraclass correlations revealed that the dist
ribution of negative symptoms was considerably more stable than that o
f positive symptoms over the interval, and subtypes based on negative
symptoms were the only ones that manifested consistent stability over
time. There was also a significant increase in negative symptom severi
ty for the sample, with a slight decrease in positive symptom severity
. Thus, even in chronic inpatients, with a very extended illness, posi
tive symptom severity is not particularly stable within patients, Thes
e data indicate that the characteristics of negative and positive schi
zophrenic symptoms are similar in younger and geriatric schizophrenic
patients, suggesting a continuity of the illness process. Tentative ev
idence for increasing severity of negative symptoms over a brief follo
w-up period suggests the possibility of a steady worsening of clinical
state in very elderly patients who remained hospitalized.