Psychosis in the Elderly PDF

Introduction

Clinicians caring for older persons have inevitably been confronted with patients presenting with a variety of clinical challenges relating to psychiatric symptoms in their patients. The usual concepts of schizophrenia whilst valid in the younger persons, do not always apply to their older patients. Paraphrenia sometimes seems a useful way of attending to a diagnostic dilemma but this too, frequently does not clarify.

Older persons have medical co morbidities which impact upon or relate to the onset and trajectory of psychotic symptoms, adding additional challenges in the treatment of the whole person.

The Coasensus Meeting at Leeds Castle which addressed the issue of sctuzophrenic illness in the older person gave us a valuable re-concept-ualisation of this major psychotic condition and serves to bring to our awareness a total review in the understanding of what psychosis is in the older person.

In the years since the publication of the consensus report following the meeting, little has been published to bring together, in the same text, the whole range of psychotic presentations in the elderly. We hope this text will serve to clarify for the clinicians and researchers a range of psychotic presentations from schizophrenia-like psychosis through all other conditions in which psychotic symptoms are a part. It brings together both the bIological, psychological and pharmacological aspects of this group of presentations, and adds to it the very important psychosocial, rehabilitation and community-based care of older persons with psychotic symptoms. Delirium, affective disorders, alcohol misuse and latrogenic conditions are also Included to address the relevant concerns of clinicians In the field.

As older persons with psychotic symptoms are much stigmatised In the community, this matter Is also highlighted and addressed.

Recognising the field is sparse in the quantum of research and it is far less attractive to researchers when compared with the avalanche of work in dementia and depression, some future direction is drawn to interested researchers.

This text is offered to clinicians in the field and we hope to provide some assistance in their diagnostics and management of older persons with psychotic prescntations Above GIl, we hope to provide a better understanding of our older patients who suffer from and whose lives are blighted by these psychotic symptoms.