WHAT DO WE REALLY KNOW ABOUT LATE-ONSET SCHIZOPHRENIA

Actual knowledge on classical late-onset schizophrenia, i.e. the schiz ophrenic disorders with onset after age 40 years, is reviewed regardin g incidence, symptomatology and course. As is shown, sound empirical k nowledge is scarce. Reasons for this are, on the one hand, the concept ual and terminological confusion which has occurred internationally re garding this illness group, and, on the other hand, the methodological limitations of the empirical studies conducted on this clinical pictu re thus far. If we only draw on classical late-onset schizophrenia, as originally defined by Bleuler, and primarily on methodologically soun d studies, as well as on own studies, we can nevertheless conclude tha t the term ''late-onset schizophrenia'' could be omitted. Late-onset s chizophrenia does not seem to be a distinct entity, but instead seems to belong to the same illness group as classical schizophrenia with ea rlier onset. Slight differences in symptomatology and course are proba bly due to unspecific influences of age. The markedly higher proportio n of women among late-onset cases, as well as our finding that symptom atology and course of late-onset women are comparably poor, could poss ibly be explained by an effect of the female sex hormone oestradiol.