Case Series With Late-Onset Psychosis Hospitalized in a Geriatric Psychiatry Unit in Turkey: Experience in 9 Years

Abstract

In this article we report the first series of Turkish inpatients with late-onset psychosis, and describe our 9-year experience at the only inpatient geriatric psychiatry department in Turkey. Among 420 patients hospitalized between 1993 and 2002, 27 were psychotic. In this group, eight patients were diagnosed as having late-onset schizophrenia (LOS) and six very-late-onset schizophrenia-like psychosis (VLOSLP). Five patients had early-onset schizophrenia and eight had delusional disorder. Females were more frequently seen in the group with LOS and the group with VLOSLP. Except for one patient with LOS, all patients with VLOSLP and LOS had paranoid psychosis. Nihilistic delusions, delusions of poverty or guilt, thought withdrawal, thought insertion, and thought broadcasting were not seen in any of the patients. Additionally, none of the LOS or VLOSLP patients showed erotomanic delusions. Grandiose and mystic delusions were not seen in those with VLOSLP. Treatment results and antipsychotic dosages at discharge were similar to those in previous reports from other cultures.

Elderly patients with very late-onset schizophrenia-like psychosis and early-onset schizophrenia: Cross-sectional and retrospective clinical findings

“…Some authors reported formal thought disorders in 100% of French-speaking VLOSLP patients [25], while other authors working mostly on English-and Deutsch-speaking patients reported a low prevalence [18], and a lower risk of formal thought disorder in VLOSLP than in EOS patients [14]. Formal thought disorder was found to be absent in VLOSLP patients in the remaining studies [20,24].…”

“…However, in most studies, negative symptoms were absent in VLOSLP [14,20] while they were present in EOS and to a lesser extent in LOS [14]. Negative symptoms were not at all or barely mentioned in several studies on VLOSLP [18,21,24,26].…”

“…Studies on VLOSLP alone [18][19][20][21][22][23], as well as studies comparing the profile of patients with VLOSLP with that of patients with LOS [14,24,25], elderly EOS [14,24,[26][27][28][29] and healthy controls [30,31] were also realized to better differentially characterize the demographics, clinical symptoms and evolution [14,20,29] of VLOSLP patients.…”

“…In terms of positive symptoms, mild paranoid delusions [14,26] mostly persecutory [18,20,21,24,25], auditory [18,21,25,26] and visual hallucinations [18,21,25], as well as all the Scale for the Assessment of Positive Symptoms (SAPS) [32] behavioral disturbances except for psychomotor abnormalities [25] were described in VLOSLP. These symptoms were sometimes as common as in LOS [25].…”

Late-Onset Psychosis; Is It Real?

“…1 As well, the diagnostic criteria proposed by the International Late-Onset Schizophrenia Group were not clearly outlined, 1 which has led to variable use of this term. 9,10,26,27 Subsequent studies directly comparing these proposed age categories on clinical and epidemiological aspects were equivocal. 9 In the current psychiatric diagnostic systems (DSM-V, ICD-10), schizophrenia and delusional disorder is only diagnostically allowed, and age-specific diagnostic terms are not included in DSM-V 24 or ICD-10.…”