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Age Disorientation in Schizophrenia

An Indicator of Progressive and Severe Psychopathology, Not Institutional Isolation

Received September 8, 1999; revised December 21, 1999; accepted January 24, 2000. From the Departments of Psychiatry and Psychology, Laboratory for Clinical and Experimental Psychopathology, Harvard Medical School, Fall River, MA. Address correspondence to Dr. Manschreck, Department of Psychiatry, Laboratory for Clinical and Experimental Psychopathology, Harvard Medical School, 49 Hillside Street, Fall River, MA 02720; e-mail: Theo.Manschreck{at}dmh.state.ma.us

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.

Key Words: Schizophrenia Spectrum Disorder • Geriatric Psychiatry • Cognition

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