[Late schizophrenia (author's transl)]

The designation "late schizophrenia" is used with reference to M. Bleuler. Of 502 cases of schizophrenia admitted to the mental hospital of the university of Bonn from 1945-1959 and later catamnestically examined, 14% were taken ill after age 40. Including the deceased, the percentage increases to 17.1 (110 of 644 cases). The onset of disturbance could be ascertained with 50% occurring equally between age 40-44 and age 45-59. Late schizophrenia became manifest after age 50 in 24. 3% and in 3.1% after age 60. The average period of observation was 17.8 years, and 20.7 years including prodromes. In 42.8% prodromes and/or signs in advance could be traced. Females predominated (64.3%). Syntonic personalities were markedly more frequent (49.3%), psychopathic primary personalities less frequent than in other schizophrenias in the first half of life. With regard to premorbid intelligence or hereditability no differences could be found. Psychic-reactive actuation (31.9%) was not significantly more frequent than in the group as a whole (25%). Not even by social factors (social class of parental family, bachelorhood rate, childlessness, and late marriage) could late schizophrenia be reliably distinguished from other schizophrenias. The quota of initially dominating paranoid-hallucinatory (55.4%) and paranoid syndromes (23.2%) is markedly higher than in schizophrenia of the first half of life, depressive moods (47.1%) and coenaesthesias (64.3%) less frequent. The final prognosis is - especially for women - more favorable, the rate of full remissions amounting 30%; 35% showed remissions to slight pure residual symptoms. All types of schizophrenic courses also occur in late schizophrenia; monophasic types are significantly more frequent, the two most prognostically unfavorable types are significantly rarer than in the group as a whole. The rate of social reintegration is with 64.3% higher and that of permanent hospitalization 10% lower than in the group as a whole. In view of the identity of late schizophrenia with all other schizophrenias, the same principles have to be applied to therapy and rehabilitation.