Elderly psychiatry Flashcards
What is late-onset schizophrenia?
Schizophrenia >45 years old.
Is there evidence of dementia with schizophrenia
No
Why are patients often hard to treat?
Often undiagnosed for a long time
Give 3 risk factors. Which gender is affected most?
Social isolation, sensory deficits, reclusive premorbid personality.
Women affected most.
Is the familial risk for relatives of late-onset schizophrenia less or more than normal schizophrenia?
Less
Describe the clinical picture. What hallucinations and delusions are common?
First rank as common as young people.
Delusions primarily persecutory.
Hallucinations in very late onset are often prominent in multiple modalities.
Patients have less negative symptoms.
Why may auditory hallucinations be worse in the elderly?
Deafness
Describe the clinical course and treatment.
Chronic, with remissions. Better outcomes than early-onset. Treated the same as normal but elderly get more SE’s of meds so can be tricky
When does delusional disorder often occur and in which gender?
Middle-late adulthood. More common in women but age of onset earlier in men
What is the main feature of delusional disorder? How long does this have to last?
Longstanding delusions, has to be >3 months to rule out delirium
Describe the delusional picture.
One key delusion or a set of interconnecting ones. Culturally appropriate, commonly skin infestation, illness/cancer, persecutory or infidelity.
Describe hallucinations in delusional disorder. What symptoms are not present?
Can be transient hallucinations but not persistent. Not 3rd person. If hallucinations are the main feature probably not delusional disorder.
No passivity phenomena or blunting of affect
How is delusional disorder treated?
Anti-psychotics
What are common delusions in psychotic depression?
Mood congruent – nihilistic, derogatory.
What are the classic hallucinations in depression?
Olfactory, and 2nd person auditory
