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Schizophrenia Into Later Life

Treatment, Research, and Policy

Edited by Carl I. Cohen, M.D.

  • ISBN 978-1-58562-037-1
  • Item #62037

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We are on the verge of a crisis in mental health. Over the next 30 years the number of chronically mentally ill people 55 years of age and older will double. With multiple disorders relating to mental illness and old age, these people will require unique services from a health care system that is ill prepared to deliver them. Schizophrenia Into Later Life: Treatment, Research, and Policy is the first major multidisciplinary reference on this important topic—a landmark work for researchers, service providers, and policy makers.

Broad in scope, it discusses the demographic and clinical characteristics of older schizophrenic persons, details treatment approaches, suggests research strategies, and covers the relevant economic and health policy issues.

  • The most up-to-date, comprehensive source of information on this understudied group. It will help community psychiatrists, gerontologists, psychologists, policy makers, and social scientists meet a growing demand for services.
  • A multidisciplinary approach with contributing experts from fields of biological psychiatry, social psychiatry, sociology, anthropology, social work, psychology, and neuropsychology will help professionals integrate services for the best outcome.
  • A primary resource on the subject—sections include epidemiology, biological aspects, psychosocial features, clinical care, and public policy.

Today there is a distressing lack of age-appropriate clinical, rehabilitative, or residential programs for older patients with chronic mental illness. Schizophrenia in Later Life: Treatment, Research, and Policy will guide researchers, service providers, and policy makers in creating innovative new programs to help this underserved and growing population.


  • Contributors
  • Introduction
  • PART I: Epidemiology, Historical Background, Illness Phenomenology, and Diagnostic Issues
  • Chapter 1. Patterns of Care for Persons 65 Years and Older With Schizophrenia
  • Chapter 2. Changes in Schizophrenia Across Time: Paradoxes, Patterns, and Predictors
  • Chapter 3. A Comparison of Early- and Late-Onset Schizophrenia
  • Chapter 4. Differential Diagnosis of Psychotic Disorders in the Elderly
  • PART II: Biological and Medical Aspects
  • Chapter 5. Biological Changes in Older Adults With Schizophrenia
  • Chapter 6. Cognitive Functioning in Late-Life Schizophrenia: Course and Correlates
  • Chapter 7. Medical Comorbidity in Older Persons With Schizophrenia
  • PART III: Gender and Sociocultural Aspects
  • Chapter 8. Gender Differences in Schizophrenia Across the Life Span
  • Chapter 9. Social Vicissitudes of Schizophrenia in Later Life
  • PART IV: Treatment and Service Issues
  • Chapter 10. What Are the Service Needs of Aging People With Schizophrenia?
  • Chapter 11. Use of Novel Antipsychotics in Older Patients With Schizophrenia
  • Chapter 12. Community-Based Treatment of Schizophrenia and Other Severe Mental Illnesses
  • Chapter 13. Biobehavioral Treatment and Rehabilitation for Older Adults With Schizophrenia
  • Chapter 14. Changing Caregiving Needs as Persons With Schizophrenia Grow Older
  • Chapter 15. Mental Health Policy and Financing of Services for Older Adults With Severe Mental Illness
  • PART V: Future Directions
  • Chapter 16. Toward the Development of Theory and Research in Aging and Schizophrenia
  • Index

About the Authors

Carl I. Cohen, M.D., is Professor and Director of the Division of Geriatric Psychiatry at SUNY Downstate Medical Center in Brooklyn, New York.

The book is an easy read and free of jargon, and it will prove informative to mental health administrators, citizen advocates for the mentally ill, and mental health clinicians. It will be important also to many general physicians who attend the elderly, especially in nursing facilities. In a book this broad, integration across topics is difficult, but in the final chapter Cohen draws from the field of gerontology to provide an integrative model that may be used to guide future research.—William T. Carpenter, M.D., New England Journal of Medicine, 1/1/2004

Cohen, with his team of practitioners and scientists, provides a fascinating look at the increasing number of older persons with schizophrenia and the need to mobilize both science and services to meet not only their needs but those of their families, who inevitably age-out of the caregiver role. The coverage is complete from biology, imaging, psychosocial approaches, and theory. There are clinically helpful chapters on diagnosis, medication, psychosocial interventions, and health care financing. The authors also examine assumptions underlying both research and services to advance the goals of both. Their work is exhaustive but inspiring and may be the most complete source available for those seeking to address the increasing problems of older Americans with serious mental illness.—Gary J. Kennedy, M.D., Professor of Psychiatry and Behavioral Science, Albert Einstein College of Medicine; Director, Division for Geriatric Psychiatry, Montefiore Medical Center, Bronx, New York

Dr. Cohen is to be congratulated for this important contribution to the literature. His long experience as a community psychiatrist is evidenced in the broad scope of this volume. The depth in which clinical, social and psycho-economic issues are covered makes this 'required reading' for those who work with elderly patients, or those with schizophrenia, in the community or, in fact, in any setting!—Stephen M. Goldfinger, M.D., Professor and Vice Chair, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, New York

Regrettably, a literature review reveals that only 1 percent of the literature on schizophrenia has addressed issues of aging. Cohen's multidisciplinary reference, which aims to provide an overview of the current state of knowledge about schizophrenia in later life and to examine the implications for service, research and policy, helps fill that gap. It will serve as a guide for much-needed planning for integrated services.—Behavioral Healthcare Tomorrow, 1/1/2004

This book is easy to read and deals with a broad spectrum of services needed for the comprehensive clinical care of people with schizophrenia. Thus, it will be a valuable reference to clinicians (e.g. physician, social worker, psychologist, case manager) and students as well as consumers.—Myung A. Lee, M.D., Journal of Clinical Psychiatry, 1/1/2004

Cohen has edited an important book that summarizes the work and research that is proceeding in a longitudinal study of the course of schizophrenia. . . . A missing resource has been put in place with the publication of this text.—F. M. Baker, M.D., MPH, The Journal of Nervous and Mental Disease, 1/1/2004

This high quality book addresses a growing issue in psychiatry. In this book, leading thinkers lend their expertise on the subject. There will no doubt be other significant works to follow.—Daniel Loiterstein, M.D., Doody's Book Reviews, 1/1/2004

For once, with a multi-author volume, I was truly appreciative of a degree of editorial diligence that has ensured true chapter complimentarity. The result is a book that I found easy to read from start to finish. I would recommend that every psychiatrist involved in the care of older people does just this. . . . Schizophrenia Into Later Life should go some way to raise awareness and concern about this enormous patient group. This book really should be on every Old Age Psychiatrist's bookshelf.—Robert Howard, International Psychogeriatrics, 1/1/2004

Schizophrenia Into Later Life is an important book on the consequential but neglected areas of research, service and policy for people with schizophrenia as they age. . . This comprehensive volume is valuable and recommended for anyone who works with, studies or develops policies for aging individuals with serious mental illness.—David R. Levine, M.D., Psychiatric Times, 1/1/2004

The strength of the book lies in its exhaustive coverage of all aspects of schizophrenia throughout the lifespan to lead to greater understanding of the issues pertinent to those patients who are moving into older age. With the anticipated doubling in numbers of elderly people with chronic mental illness in the next 30 years it will become increasingly important for old age psychiatrists to be able to manage this group effectively and as a complete source this book is indispensable reading. Indeed as an in-depth overview of schizophrenia throughout the life cycle it would be valuable reading for all psychiatrists and an ideal revision source for trainees.—International Journal of Geriatric Psychiatry, 1/1/2004

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