Schizophrenia and delusional disorder in older age: Community prevalence, incidence, comorbidity, and outcome
Schizophrenia and delusional disorder in older age: Community prevalence, incidence, comorbidity, and outcome
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DOI：
10.1093/oxfordjournals.schbul.a033307
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发表时间：
1998-01-01
影响因子：
6.6
通讯作者：
McKibbin, PE
中科院分区：
文献类型：
--
作者：
Copeland, JRM;Dewey, ME;McKibbin, PE
对精神分裂症和妄想障碍的患病率、发病率和转归进行评估的机会来自年龄和性别分层的5，222例65岁及以上的随机样本，该样本选自全科医生名单，并由接受过使用老年精神状态（GMS）-AGECAT计算机诊断系统培训的精神科护士进行访谈。GMS-AGECAT确保了两波研究之间病例选择的可靠性，一个子样本由研究精神病学家进行访谈，样本在2年后使用相同的方法进行随访，访谈者对最初的发现不知情，由临床医生审查AGECAT诊断的精神分裂症/偏执狂障碍的所有提名病例和子病例的方案，并进行DSM-III-R诊断，初次访谈（第1波）的拒绝率为13%，2年后（第2波）的重新访谈为15%，DSM-III-R精神分裂症的患病率为0.12%（95%置信区间[CI] 0.04-0.25）和妄想症0.04%（95%CI 0.00-0.14），新发病例中精神分裂症的最低发病率为3.0（95% CI 0.00 - 110.70）;对于新发和复发病例，45.0（95% CI 3.54-186.20）;妄想症为15.6（95% CI 0.02-135.10）/10万人/年，5例精神分裂症患者中有2例在65岁以前首次确诊，2年后，没有一个精神分裂症病例完全康复，但在随访时没有一个被迷惑，两个发展为痴呆，结果很差，因为他们仍然是某种精神疾病的病例，但结果很好，因为他们的精神分裂症/妄想障碍症状有所改善。
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.