Schizophrenia and Related Psychotic Disorders During Mid- to Late-Life

Presenter:

Laura M. Rowland, Ph.D.
Jovier D. Evans, Ph.D.
Division of Translational Research

Goal:

This concept aims to encourage translational research to better understand the emergence, trajectory, and outcomes of schizophrenia and related psychotic disorders in mid- to late-life, and to identity targets for future development of prevention and treatment interventions.

Rationale:

Schizophrenia and related psychotic disorders affects ~20 million people worldwide and is one of the top 15 leading causes of disability. Those living with schizophrenia and related psychotic disorders on average have a shorter lifespan and greater morbidity than the general population. The majority of people living with schizophrenia and related psychotic disorders are in mid- to late-life, including those first diagnosed (~ 20-25% of cases with schizophrenia emerge after ~35 years of age) and those aging with the illness. Individuals living with schizophrenia and related psychotic disorders in mid- to late-life have the highest amount of disability-adjusted life years compared to individuals with schizophrenia and related psychotic disorders of any other age group. Research focused on people living with schizophrenia and related psychotic disorders in mid- to late-life is sparse. The mechanisms underlying the emergence and trajectory of schizophrenia and related psychotic disorders during mid- to late are poorly understood. Research is critically needed that is focused on better understanding of the mechanisms underlying the emergence, course, and outcomes of schizophrenia and related disorders during mid- to late-life to help identify targets for new prevention and treatment efforts.

Research gap areas include but are not limited to 1) phenomenology, etiology and pathophysiology of first-episode psychosis that emerges during mid- to late-life ; 2) the underlying mechanisms and trajectory of psychosis, negative symptoms, cognition, social cognition, and functioning during mid- to late-life; 3) the underlying neurobiological and other mechanisms (e.g. behavioral, social determinants of health) for the increased risk of dementia among people with schizophrenia and related psychotic disorders; 4) accelerated biological aging that may influence psychopathology, premature morbidity, and mortality among people with schizophrenia and related psychotic disorders; and 5) identification of treatment targets and the development of novel interventions to improve health outcomes. Research examining understudied populations including women and minoritized groups would help fill an additional research gap.