Late Onset Schizophrenia and Delusional Disorder

Question 1

What is psychosis?

Answer 1

A group of symptoms

• Delusions
• Hallucinations
• Thought disorder

Question 2

What is a delusion?

Answer 2

Fixed, false, unshakeable derived belief that is inconsistent with the social and cultural values of that person

Question 3

What is a hallucination?

Answer 3

A perception without a stimulus with the quality of a true percept and within the external environment

Question 4

What is thought disorder?

Answer 4

Illogical flow of thinking process

Question 5

What are some causes of psychosis in the elderly?

Answer 5

• Dementia
  
  • Delirium
  • Substance abuse
  • Side-effects of medications
  • Medical conditions
  • Sensory deprivation
  • Depression
  • Mania, primary or secondary
  • Chronic psychiatric disorder
    
    • Late onset psychiatric disorder

Question 6

How does late onset schizophrenia and delusional disorder usually present?

Answer 6

• Premorbidly long standing suspiciousness, isolation, and difficulties with relationships
• Delusions are usually persecutory, hypochondriacal, partition delusions
• Deafness and visual impairment is often associated

Question 7

How do you differentiate very late Schizo from chronic schizo

Answer 7

• Very late have multimodal hallucinations, preserved personality, and don’t have thought disorder
• And they’re typically socially isolated

Question 8

How do you differentiate very late Schizo from dementia with psychosis

Answer 8

• Assess cognitive function

- Longitudinal assessment of functional status - dementia will decline where vl psychosis it should be preserved

Question 9

How do assess capacity in psychosis?

Answer 9

Give information
Assess whether they can process it and weight the risk and benefits, and the consequences
If the psychosis drives the decision then they don’t have capacity