© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Schizophrenia and Delusional Disorder in Older Age: Community Prevalence, Incidence, Comorbidity, and Outcome
Professor and Chairman, University of Liverpool, Department of Psychiatry, Institute of Human Ageing, Royal Liverpool University Hospital Liverpool, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Senior Lecturer, Trent Institute for Health Services Research, and Deputy Director, Queens Medical Centre, University of Nottingham Nottingham, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Experimental Officer, Centre for Social Policy Research and Development, University of Wales Bangor, Wales All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Senior Registrar, General and Rehabilitation Psychiatty, West Cheshire National Health Service Trust Chester, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Consultant in Old Age Psychiatry, Stepping Hill Hospital, Stockport, and Honorary Associate Lecturer, School of Psychiatry and Behavioural Sciences, University of Manchester Manchester, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Lecturer in Statistics, Department of Public Health and Mathematical Sciences, University of Liverpool Liverpool, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Lecturer in Statistics, Department of Psychiatry, Royal Liverpool University Hospital Liverpool, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Project Co-ordinator, Department of Psychiatry, Royal Liverpool University Hospital Liverpool, England All the authors were members of the University of Liverpool Department of Psychiatry at the time of the study
Reprint requests should be sent to Dr. J.R.M. Copeland, Dept. of Psychiatry and Institute of Human Ageing, University of Liverpool, P.O. Box 147 Liverpool L69 3BX, England
The opportunity to assess prevalence, incidence, and outcome of schizophrenia and delusional disorder was provided by an age- and sex-stratified random sample of 5,222 persons age 65 years and over. This sample was chosen from general practitioner lists, and interviewed by psychiatric nurses trained to use the Geriatric Mental State (GMS)-AGECAT computerized diagnostic system. GMS-AGECAT ensured the reliability of the selection of cases between the two waves of the study. A subsample was interviewed by a research psychiatrist. The sample was followed up 2 years later using the same method by interviewers blind to the initial findings. The protocols of all nominated cases and subcases of schizophrenia/paranoid disorder diagnosed by AGECAT were reviewed by a clinician and DSM-III-R diagnoses were made. Refusal rate was 13 percent for initial interviews (wave 1) and 15 percent for reinterview 2 years later (wave 2). The prevalence of DSM-III-R schizophrenia was 0.12 percent (95% confidence interval [CI] 0.04–0.25) and delusional disorder 0.04 percent (95% CI 0.00–0.14). The minimum incidence of schizophrenia for new cases was 3.0 (95% CI 0.00 to 110.70); for new and relapsed cases, 45.0 (95% CI 3.54–186.20); and for delusional disorder, 15.6 (95% CI 0.02–135.10) per 100,000 per year. Two of the five cases with schizophrenia were known to have been first diagnosed before age 65. After 2 years, none of the cases of schizophrenia had recovered fully, but none was deluded at followup. Two had developed dementia. The outcome was bad because they remained cases of some type of psychiatric illness but good because of the improvement in their schizophrenia/delusion disorder symptoms.
Keywords: Delusional disorder / comorbidity / incidence / prevalence
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