PSYCHOTIC DISORDERS
American Psychological Association
Table of Contents
Why Practitioners Need Information
- Schizophrenia rarely occurs for the first time in older age. Only 10 percent of people suffering from schizophrenia experience the onset of the disorder after age 40. Consequently, older adults with schizophrenia often have a history of chronic psychotropic use and institutionalization. Older age appears to be related to reduction in frequency and severity of positive symptoms of the disorder, such as hallucinations and delusions. However, because of other aspects of schizophrenia, such as apathy and withdrawal, older people with schizophrenia are at high risk for social isolation and neglect by the mental health system.
- The most common form of psychosis in later years is paranoia. Hearing loss may be one important risk factor for developing late-life paranoia. Other risk factors are social isolation, a long-standing personality disorder, dementia, and delirium. Paranoia in older adults tends to be characterized by beliefs that are less bizarre than those reported by younger adults. People may be able to function adequately and demonstrate normal cognitive functioning. Unfortunately, because older adults with paranoia often have delusions related to relatives, friends, and caregivers, the disorder is especially likely to result in increased social isolation.
