SEVERITY OF SYMPTOMS IN CHRONICALLY INSTITUTIONALIZED GERIATRIC SCHIZOPHRENIC-PATIENTS

Objective: The goal of this study was to characterize the symptoms of geriatric, chronically ill, institutionalized schizophrenic patients a nd investigate age-related differences in schizophrenic symptoms and c ognitive performance from early adulthood to late senescence. Method: The Positive and Negative Syndrome Scale and the Mini-Mental State exa mination were used to assess the schizophrenic symptoms and cognitive performance, respectively, of 393 institutionalized schizophrenic pati ents stratified into seven groups designated by 10-year age intervals from 25 years to over 85 years. Results: In the comparisons of the sev en age groups, significant differences between groups in positive and negative subscale scores on the Positive and Negative Syndrome Scale a nd in Mini-Mental State scores were revealed. Significant correlations between Mini-Mental State scores and Positive and Negative Syndrome S cale negative symptom scores, but not positive symptom scores, were fo und for all age groups, except for the youngest patients studied. Curr ent treatment with neuroleptics and prior treatment with ECT, insulin coma, or leukotomy could not account for the poor cognitive performanc e of the older schizophrenic patients. Conclusions: The older schizoph renic patients continued to experience psychotic and nonpsychotic symp toms in senescence. Their positive symptoms were moderately less sever e and their negative symptoms and cognitive impairment were significan tly more severe than those of the younger patients. Somatic treatment appeared not to be responsible for the severe cognitive impairment and negative symptoms of the older patients. These data are relevant to c hronically hospitalized geriatric schizophrenic patients but not neces sarily to all geriatric schizophrenic Patients.