The Difference In Clinical Characteristics And Therapeutic Efficacy Between Early-and Late-Onset Patients With Schizophrenia

Background:Age of onset may impact clinical characteristics and treatment outcomes.Thus,early-and late-onset schizophrenia may be different.Objective:To investigate the differences in demographics,clinical symptoms,cognition,and symptom improvement after 8 weeks between early-onset schizophrenia(EOS)and late-onset schizophrenia(LOS).Methods:Totally,305 individuals with schizophrenia were enrolled.They were divided into two groups based on the age of onset:①EOS is defined as the onset before the age of 18(n=134).②LOS is defined as the onset age between 40 and 59(n=171).Positive and Negative Sydorme Scale(PANSS),MATRICS Consensus Cognitive Battery(MCCB)were used to assess clinical symptoms and cognition function at baseline.PANSS was also used after 8-week treatment.Chi-square test and independent t test was used to compare the differences between first-onset and late-onset schizophrenia patients in demographics,family history and baseline characteristics on PANSS and MCCB.Random effect model was used to compare the changes on PANSS scores before and after 8 weeks changes.Results:The median of age of early-onset patients was 18(IQR=17,18)years old;That for the late-onset patients was 42(IQR=41,44)years old.Chloropromazine equivelance dosage was higher among late-onset patients(Median 427,IQR 287)than among early-onset patients(Median 341,IQR 215;Z=-2.01 P=0.04).At baseline,early-onset patients had higher scores on the PANSS general psychopathological subscale(t=2.8 P=0.01)and the depression factor scores of the PANSS(t=2.53 P=0.01);early-onset performed more poorly in MCCB information processing speed(t=-2.24 P=0.03),working memory(t=-2.63 P=0.01),attention/alertness(t=-2.32,P=0.02)than late-onset patients.Early onset and family history had interactive effects on the score of the PANSS general psychopathology subscales.After 8-weeks psychotics therapy,early-onset schizophrenia patients still had higher scores on the scores of the PANSS general psychopathology subscales.After 8-weeks psychotics therapy,early-onset schizophrenia patients had higher scores on the scores of the PANSS positive symptoms subscales,negative symptom subscales,and positive factor scores(group × time,P value,0.017,0.011,0.001)and total PANSS scores(β=4.35,P=0.001)compared to the late-ontset patients;the therapy can reduce on all subscale or factor scores of the PANSS.Conclusion:Early-onset and late-onset schizophrenia patients were different in age,family history,cognitive function,clinical symptoms,drug dose.Early-onset schizophrenia patients also had severer cognitive impairment compared those with late-onset schizophrenia.It suggests that there may be different pathogenesis between early-onset and late-onset schizophrenia.