Paranoid psychosis in the elderly. A follow-up study

Hospital records comprising 106 first admissions of patients aged 60 years or more diagnosed paranoid disorder were studied. Affective psychosis and dementia were excluded. The female/male ratio was 2:1. Symptomatology, treatment and diagnostic classification are presented. Seventy-five per cent revealed persecutory delusions, and nearly half were hallucinated. Almost all patients received neuroleptics. The majority were diagnosed paranoid psychosis or reactive psychosis. After 5-15 years of observation a full remission was seen in 27% according to the judgement of general practitioners as well as hospital records. Delusions such as megalomania and delusions with ideas of sex and jealousy showed a significantly poor outcome. The diagnosis reactive psychosis predicts a course of illness characterized by few relapses.