Age disorientation in schizophrenia: an indicator of progressive and severe psychopathology, not institutional isolation.

The authors investigated age disorientation in chronic schizophrenia to determine whether specific symptomatic, neurologic, and cognitive disturbances were linked to its presentation. Disorientation to their age was detected in 30% (16/54) of the schizophrenic patients in a chronic care facility. In matched comparisons, age-disoriented patients showed lower educational achievement, poorer mental state performance, and a greater severity of symptoms, as well as more severe motor and sensory impairments. Levels of social withdrawal did not differentiate the two groups. A two-hit model consistent with neurodevelopmental and neurodegenerative processes is proposed to explain the data.

[1]  Philip D. Harvey,et al.  Age disorientation in chronically hospitalized patients with mood disorders , 1996, Psychiatry Research.

[2]  R J Wyatt,et al.  Neuroleptics and the natural course of schizophrenia. , 1991, Schizophrenia bulletin.

[3]  B. Maher,et al.  Repetition in Schizophrenic Speech , 1985, Language and speech.

[4]  J. Olney,et al.  Glutamate receptor dysfunction and schizophrenia. , 1995, Archives of general psychiatry.

[5]  T. Crow,et al.  Age Disorientation in Schizophrenia: A Constant Prevalence of 25 per cent in a Chronic Mental Hospital Population? , 1978, British Journal of Psychiatry.

[6]  J. Waddington,et al.  Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dyskinesia , 1996, Psychological Medicine.

[7]  J. Ragland,et al.  Dementia Praecox Revisited , 1988, British Journal of Psychiatry.

[8]  W. Fenton,et al.  Line drawing as a possible measure of lateralized motor performance in schizophrenia , 1997, Schizophrenia Research.

[9]  Joseph T. Coyle,et al.  The Glutamatergic Dysfunction Hypothesis for Schizophrenia , 1996, Harvard review of psychiatry.

[10]  B. Maher,et al.  Semantic priming in thought disordered schizophrenic patients , 1988, Schizophrenia Research.

[11]  T. Crow,et al.  Age Disorientation in Chronic Schizophrenia is Associated with Global Intellectual Impairment , 1984, British Journal of Psychiatry.

[12]  E. Walker,et al.  Neuromotor precursors of schizophrenia. , 1994, Schizophrenia bulletin.

[13]  T. Manschreck,et al.  Neurologic features and psychopathology in schizophrenic disorders. , 1984, Biological Psychiatry.

[14]  G. A. Miller,et al.  Verbal context and the recall of meaningful material. , 1950, The American journal of psychology.

[15]  T. Crow,et al.  Age Disorientation in Chronic Schizophrenia is Not Associated with Pre-morbid Intellectual Impairment or Past Physical Treatment , 1988, British Journal of Psychiatry.

[16]  T. Crow,et al.  Further Investigation of the Predictors of Outcome Following First Schizophrenic Episodes , 1990, British Journal of Psychiatry.

[17]  Philip D. Harvey,et al.  Cognitive functioning in chronically hospitalized schizophrenic patients: age-related changes and age disorientation as a predictor of impairment , 1995, Schizophrenia Research.

[18]  R Tandon,et al.  Age disorientation in Kraepelinian schizophrenia: frequency and clinical correlates. , 1993, Psychopathology.

[19]  Alexander L. Miller,et al.  Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects. , 1993, The American journal of psychiatry.

[20]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[21]  T. Crow,et al.  Age Disorientation in Chronic Schizophrenia: The Nature of the Cognitive Deficit , 1978, British Journal of Psychiatry.

[22]  J. Kane,et al.  Research diagnoses for tardive dyskinesia. , 1982, Archives of general psychiatry.

[23]  Robert W. Buchanan,et al.  The neurological evaluation scale (NES): A structured instrument for the assessment of neurological signs in schizophrenia , 1989, Psychiatry Research.

[24]  D. Cath,et al.  Low prevalence of age disorientation in Dutch long-stay patients , 1995, Schizophrenia Research.

[25]  B. Maher,et al.  Disturbed voluntary motor activity in schizophrenic disorder , 1982, Psychological Medicine.