Cross-sectional Study On Chronic Elderly Schizophrenic Patients In Taiwan: Symptoms, Cognition And Functioning

Objective:To investigate the current clinical condition and related factors of Taiwan elderly schizophrenic patients.It may help to provide the scientific basis for management,deterioration prevention and long-term care policy making.Methods:1.By using cross-sectional study method,we investigate all the hospitalized elderly schizophrenia patients in one psychiatric institution in Toufen,Maioli,Taiwan during June to September in 2007.All the subjects must match the diagnostic criteria of DSM-Ⅳ-TR and age 60 years old or above.Total 52 subjects were enrolled.2.After getting the informed consent,all the subjects were evaluated by using face-to-face interview with psychosocial testing.Demographic data,illness history,Positive and Negative Syndrome Scale(PANSS), Center for Epidemiological Studies Depression Scale(CES-D), Wisconsin Card Sorting Test(WCST),Mini-Mental Status Examination (MMSE),Cognitive Abilities Screening Instrument(CASI),Activities of Daily Living Rating ScaleⅢfor Psychiatric Patients,Community Self-Sufficiency Test,Schizophrenia Quality of Life Scale(SQLS),Short Form-36 Health Survey(SF-36) and the General Assessment of Functioning Scale(GAF) were administeredResults:1.The demographic data of the subjects were mainly male(59.6%), mean age is 65.7 years old,married(75.0%),education level were under 6 years(65.4%),instituted(96.2%) with the mean age of onset were 37 years old.2.With comparison with PANSS China norms,the positive scale score was found to be lower(T=-14.51,p<.05),the negative and the general psychopathology scale score were higher(T=6.78,3.64,p<.05). The total score had no statistical significant(T=-0.99,p>.05).3.With comparison with the norms of the Western WCST 65-74 years old,we found that「perseverative responses」,「total errors」及「% perseverative errors」had higher score(T=6.9,21.61,7.28,p<.05) but「%conceptual level responses」had lower score(T=-29.46 p<.05).The mean score of MMSE and CASI is 16.88 and 44.35 respectively,showed to have already exceeded the cut off score.4.With comparison with the norms of the Taiwan age 18-60 Activities of Daily Living Rating ScaleⅢfor Psychiatric Patients score, the self-care subtotal,independent living subtotal and the total score were lower(T=-3.84,-7.80,-8.81,p<.05)5.With comparison with SF-36 China norms,all the subscale score(physical functioning(PF),role limitations due to physical health (RP),bodily pain(BP),general health perceptions(GH),vitality(VT), social functioning(SF),role limitations due to emotional problems(RE), and general mental health(MH)) were lower(T=-4.80,-4.91,-2.02,-3.46,-6.19,-4.19,-4.68,-4.74,p<.05).In SQLS,the 'motivation and energy',and 'symptoms and side-effects' subscale score were higher the Chinese norms(T=9.58,4.04,p<.05)6.The different demographic background variable measures found to have no statistical significant between different measurements except in few items.7.The social functioning was found to have correlation with the PANSS negative score,general psychopathology score,total score, cognitive function,and GAF score.8.The cognitive functioning was found to have correlation with the PANSS negative score,general psychopathology score,total score,social function,SQLS and GAF score.Conclusions:1.Chronic elderly schizophrenia PANSS total score had no statistical different with compared with young age norms,but the positive score is lower with more severe in negative and general psychopathology score.2.Chronic elderly schizophrenia was found to have cognitive impairment,decline in social functioning,and poor outcome with poor quality of life.3.Chronic elderly schizophrenia prognosis may be related to negative symptoms,general psychopathology symptoms,social and cognitive function but not positive symptoms.4.There was correlation between cognitive and social function in chronic elderly schizophrenic patients.