Late life psychosis Flashcards
1
Q
Paraphrenia
A
-Kraepelin
2
Q
Involutional paranoia
A
-Kleist
3
Q
Psychosis
A
- delirium
- drug induced
- medical conditions
- Alzheimers
- LBD
- Parkinsons
4
Q
Late onset psychosis
A
-divided between late onset (after 40 years)
and very late onset (onset after 60 years)
5
Q
Late paraphrenia
A
- 10% elderly population of a psychiatric hospital
- auditory hallucinations in 75%, visual hallucinations in 60%
6
Q
Delusions
A
- less common (10–20%)
- Partition delusions are common (attack through the wall or ceiling, neighbours spying) are common
7
Q
Characteristics of late onset schizophrenia
A
- fewer negative symptoms
- better response to antipsychotics
- better neuropsychoogical performance
- greater likelihood of visual hallucination
- a lesser likelihood of formal thought disorder
- lesser likelihood of affective blunting
- greater risk of developing tardive dyskinesia
8
Q
Tardive dyskinesia
A
- risk increased with older antipsychotics
- 5-6x more likely in old people
9
Q
Familial risk
A
-relatives of very-late onset patients have a lower morbid risk for schizophrenia than the relatives of early onset schizophrenia patients
10
Q
Prevalence of schizophrenia
A
- 7%in siblings
- 3% in parents
11
Q
Risk factors for late onset psychosis
A
- age related changes in frontal or temporal cortices
- cognitive decline
- social isolation
- sensory deprivation
- polypharmacy
- presence of paranoid and schizoid personality traits
- female sex
- family history
- precipitating life events
12
Q
Treatment
A
- LBD must be excluded before antipsychotics are used
- TDs are more common
- vascular risk in second generation
- improvement of psychotic symptoms is seen in haloperidol and trifluoperazine
- clozapine can be used
