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First-onset functional brief psychoses in the elderly.
Yoram Barak1, Daniel Levy, Henry Szor
1Abarbanel Mental Health Center, Bat-Yam ; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Diagnoses of nonorganic psychosis in the elderly are common. Many patients experience diagnostic shifts, requiring flexible treatment approaches for late-life psychosis.
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Area of Science:
- Geriatric Psychiatry
- Psychopathology
- Clinical Neuroscience
Background:
- The origin and diagnostic classification of psychotic disorders emerging in late life are not well-established.
- Understanding the diagnostic trajectory of these conditions is crucial for effective clinical management.
Purpose of the Study:
- To assess the diagnostic stability of brief psychotic disorders with onset in elderly individuals.
- To investigate the long-term diagnostic outcomes for late-life psychosis.
Main Methods:
- A 10-year retrospective analysis of medical records was conducted.
- Included were elderly patients (≥65 years) experiencing their first episode of psychosis.
- Organic psychoses were excluded, focusing on nonorganic diagnoses.
Main Results:
- Out of 2,072 elderly admissions, 604 met criteria for brief psychotic disorder.
- The study included 83 patients (mean age 75.4 years) with a mean follow-up of 27.7 months.
- Most common initial diagnoses were unspecified nonorganic psychosis (n=71), followed by persistent delusional disorder (n=10).
- Frequent outcomes at follow-up included very late-onset schizophrenia-like psychosis and transitions to other brief psychotic disorders.
Conclusions:
- Nonorganic psychosis presenting in late life is a significant clinical issue in tertiary care settings.
- Diagnostic evolution is more prevalent than previously thought, necessitating adaptive diagnostic and treatment strategies for elderly patients with psychosis.