Age on first hospitalization of schizophrenics: A developmental approach.

Ages of first hospitalization were compared among 64 (VA) Veterans Administration hospital male, 60 state hospital male, and 60 state hospital female schizophrenic patients. Those who were diagnosed as paranoid were found to be approximately 8 years older than the nonparanoid patients on age of first admission. In both diagnostic categories men were hospitalized about 5 years earlier than women. An analysis of the relation between work status and diagnosis for the female groups revealed that working women with a diagnosis of paranoid were hospitalized approximately 10 years later than the paranoid women who remained at home and the nonparanoid women of either employment status. State hospital males were younger on first admission than VA hospital males. The ages of the two diagnostic groups in the VA were comparable, whereas in the state hospital the nonparanoid group was younger than the paranoid group by about 8 years. Possible explanations for these findings are discussed, particularly in terms of the role of the individuals developmental level in premorbid functioning, diagnosis, and course of psychiatric illness. The need to pay greater attention to the differences between schizophrenic males and females and to scrutinize more closely differences between state and VA hospital patients is emphasized. In the literature dealing with psychopathology, studies of prognosis are usually confined to the course of a disorder following its onset, typically defined by when the individual comes into contact with a provider of mental health services. An important feature of textbook descriptions of the course of various mental disorders is the age of initial onset. Evidence has now been presented that age of first treatment and outcome are related, with a later first psychiatric treatment associated with a better outcome (Rosen, Klein, Gittelman-Klein, 1971). Yet, a recognized measurement problem here is that some unspecified time interval elapses