The Case for a Psychological Perspective on Late-Onset Psychosis

1997 ◽  
Vol 31 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Anne Hassett
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Late Life ◽  
Personality Factors ◽  
Elderly Persons ◽  
Developmental Studies ◽  
Vulnerability Factors ◽  
Future Directions ◽  
Self Image

Objective:A conceptual framework is proposed for studying late-onset psychotic disorders. This incorporates developmental and psychological perspectives to complement the biological focus of most recent studies in this area. Method:Studies of late-onset psychosis that focus on the specificity of neuroimaging abnormalities, family history and sensory deficits were reviewed. Aspects of the developmental and personality literature were then examined with the goal of ascertaining their relevance for the emergence of psychosis in late life. Possible future directions incorporating biological and psychological approaches are proposed. Results:The biological abnormalities identified in studies of late-onset psychosis lack the specificity to stand alone as aetiological factors. Neuroimaging changes and sensory impairment are commonly found in study subjects; however, they also occur in elderly persons without psychiatric illness as well as in those with other late-onset psychiatric disorders. Perhaps it is more appropriate to regard these changes as conferring a vulnerability to psychosis in old age, but symptoms do not develop unless other risk factors, either longstanding or ageing-related, are also present. Developmental studies of late life that have used Erikson's concept of a final lifestage crisis of achieving ‘ego-integrity’, suggest that personality style may be influential in determining the negotiation of this last maturational task. Failure to do so results in ‘despair’, fragmentation of self-image and paranoid fears. To date, there has been little investigation of the relevance of these developmental and personality factors for the emergence of psychosis in old age. Conclusions:If we are to advance our understanding of late-onset psychotic disorders, research in this area needs to move beyond the elusive search for specific biological markers. A model of causation that integrates the longitudinal perspective of lifestage tasks with personality and biological vulnerability factors provides a broad framework which protects against premature foreclosure on aetiological determinants.

Treatment of psychoses in the elderly

1996 ◽  
Vol 2 (3) ◽  
pp. 133-139
Author(s):  
A. Phanjoo
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Elderly ◽  
Functional Psychoses ◽  
First Time ◽  
Paranoid Psychosis

Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.

Assessing Diagnosis and Symptoms Profiles of Late-Life Psychosis

GeroPsych ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Ali Javadpour ◽  
Maryam Sehatpour ◽  
Arash Mani ◽  
Ali Sahraian
Keyword(s):  
Differential Diagnosis ◽  
Mood Disorders ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Late Life ◽  
Psychotic Symptoms ◽  
Elderly Persons ◽  
Visual Hallucinations ◽  
Symptom Profiles ◽  
Symptom Profile

Background: There are many controversies with regard to the nosology and conditions causing psychosis in old age people. This study defines a symptom profile and differential diagnosis of late-onset psychosis. Method: 201 elderly persons with psychotic symptoms were recruited. All patients were interviewed based on SCID-1 to confirm the possible diagnosis. Results: The most delusional symptom reported by the subjects was persecutory delusion, and visual hallucinations were the most common hallucination. The most repeated diagnosis was dementia, followed by psychosis due to mood disorders, primary psychotic disorders, delirium, and psychosis due to medical conditions. Conclusions: Results from the current study indicate that late-life psychoses form a heterogeneous group of disorders with varying symptom profiles and etiologies.

A Delphi study of late-onset personality disorders

2019 ◽  
Vol 31 (07) ◽  
pp. 1007-1013 ◽  
Author(s):  
Erlene Rosowsky ◽  
Emily Lodish ◽  
James M. Ellison ◽  
S. P. J. van Alphen
Keyword(s):  
Personality Disorders ◽  
Old Age ◽  
Assisted Living ◽  
Delphi Study ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Core ◽  
The Usa ◽  
The Uk

ABSTRACTObjectives:The DSM-5 describes personality disorders (PDs) as emerging in early life and remaining continuous throughout the life-span. Yet case studies and expert opinion support the existence of late-onset PDs. Little is known about PDs in late life, and our instruments for assessing them are not well validated. Thus, the focus of this exploratory Delphi study was the late-onset PD, with special attention to the accuracy of the core criteria for the diagnosis.Design:A Delphi study was designed to assess the presentation of PDs in late life. The Delphi consisted of three successive rounds of inquiry. Between rounds, the participants were provided with a summary of the panel’s responses.Participants:A panel of 21 experts included published authors, researchers, and teachers from the USA, the UK, Australia, France, Belgium, and the Netherlands.Measurements:Researchers designed a survey that included an introduction, a demographic questionnaire, and five questions that varied in presentation and response format.Results:Experts reached consensus that a variant of PD appears de novo in old age. The core features of inflexibility and pervasiveness may not pertain to late-onset PD. There was agreement that frequently occurring life events contribute selectively to the expression of late-onset PD, with the major ones being death of a spouse or partner and transition to a nursing or assisted-living facility.Conclusions:Nearly all participants took the position that PD can present for the first time in old age and be clinically identifiable without having been so identified earlier in life.

Is attention related with pathological personality in siblings of psychotic patients?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1455-1455
Author(s):  
L. Moreno ◽  
J. Valero ◽  
A.M. Gaviria ◽  
A. Labad
Keyword(s):  
Selective Attention ◽  
Sustained Attention ◽  
Psychotic Disorders ◽  
Hierarchical Cluster ◽  
Personality Factors ◽  
Healthy Controls ◽  
Vulnerability Factors ◽  
Schizotypal Personality ◽  
Attentional Deficits ◽  
Attentional Performance

IntroductionImpaired sustained and selective attention have been seen as vulnerability factors to psychotic disorders. Relatives of psychotic patients are a risk population for psychosis, and previous studies have shown that they displayed more attentional deficits compared with healthy controls. Additionally, relatives have more pathological personality and schizotypy, the least considered also to be the expression of the genetic vulnerability to schizophrenia. There are few studies that relate attention to personality factors in relatives of psychotic patients.AimsTo compare attentional performance of siblings of psychotic patients with those of healthy controls, taking into account their pathological and schizotypal personality.MethodsThe Spanish version of the SPQ and the DAPP-BQ were administered to a sample of 51 subjects that were divided into four groups by a hierarchical cluster analysis: siblings with high pathological personality (SHPP), siblings with low pathological personality (SLPP), controls with high pathological personality (CHPP), and controls with low pathological personality (CLPP). In all the subjects we assessed a sustained attention index (SUA) and a selective attention index (SEA). We compared the performance of the four groups on these attentional indexes.ResultsWe found that SHPP had worse performance on sustained attention compared with CLPP. Specifically this difference was in the reaction time item of the SUA.ConclusionsThe high schizotypy and pathological personality had an influence on sustained attentional performance in the siblings of patients with psychosis, but not in the healthy controls.

P.309 Late-life depression: How do patients with early-onset vs late-onset differ in clinical features and treatment response?

2020 ◽  
Vol 31 ◽  
pp. S52-S53
Author(s):  
W.R. Chae ◽  
M. Fuentes Casan ◽  
F. Gutknecht ◽  
A. Ljubez ◽  
S.M. Gold ◽  
...  
Keyword(s):  
Treatment Response ◽  
Clinical Features ◽  
Early Onset ◽  
Late Onset ◽  
Late Life ◽  
Late Life Depression

A controlled family study of late-onset non-affective psychosis (late paraphrenia)

1997 ◽  
Vol 170 (6) ◽  
pp. 511-514 ◽  
Author(s):  
R. J. Howard ◽  
C. Graham ◽  
P. Sham ◽  
J. Dennehey ◽  
D. J. Castle ◽  
...  
Keyword(s):  
At Risk ◽  
Late Onset ◽  
Psychiatric Morbidity ◽  
Late Life ◽  
Lifetime Risk ◽  
First Degree Relatives ◽  
Healthy Elderly ◽  
Increased Risk ◽  
Age Range ◽  
The Relationship

BackgroundThe relationship between those schizophrenia-like conditions that have their onset in late life and early-onset schizophrenia is unclear. Very few family history studies of patients with late-onset psychosis have been reported, and it is not known whether their relatives have an increased risk of psychosis.MethodInformation was collected on the psychiatric morbidity of 269 first-degree relatives of patients with schizophrenia or delusional disorder with an onset after the age of 60 (late paraphrenia), and 272 first-degree relatives of healthy elderly control subjects, using a research diagnostic instrument.ResultsWith a narrow age range (15–50 years) at risk, the estimated lifetime risk of schizophrenia was 1.3% in the relatives of both cases and controls. With a wider age range (15–90 years) at risk, estimated lifetime risk of schizophrenia was 2.3% for the relatives of cases, and 2.2% for the relatives of controls. However, depression was significantly more common among the relatives of cases than controls.ConclusionThose schizophrenia-like psychoses with onset in late life are not genetically associated with schizophrenia.

scholarly journals Mania in late life

2011 ◽  
Vol 17 (5) ◽  
pp. 357-364
Author(s):  
Felicity Richards ◽  
Martin Curtice
Keyword(s):  
Older People ◽  
Old Age ◽  
Specific Treatment ◽  
Late Life ◽  
Aging Population ◽  
Age Group ◽  
Treatment Algorithms ◽  
Assessment And Treatment ◽  
Old Age Psychiatry ◽  
Older Populations

SummaryMania in late life is a serious disorder that demands specialist assessment and management. However, it is greatly under-researched, with only a paucity of studies specifically analysing older populations. The mainstay of the old age psychiatry workload will inevitably be concerned with assessing and managing dementia and depression, but the steady rise in the aging population with longer survival means that there will be an increase in absolute numbers of older people presenting with mania. There are no specific treatment algorithms available for mania in late life. This article reviews mania and hypomania in late life and concentrates on diagnosis, assessment and treatment, as well as on the management considerations associated with this important age group.

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