Objective: The topic of course and outcome of very-late-onset schizophrenia-like psychosis (VLOSLP) has not received the research attention it deserves. The aim of this study was to evaluate the course of clinical symptoms and functional status of patients with VLOSLP in comparison with patients with life-long schizophrenia.
Methods: Telephone interviews were conducted on primary caregivers of 21 patients with VLOSLP who had recently been released from inpatient care. Their treating staff evaluated 21 schizophrenia inpatients according to the same criteria.
Results: The majority of patients with VLOSLP did not present cognitive and functional deterioration. On the other hand, 8 of the 19 patients in the elderly schizophrenia group had some functional decline; 3 of those 8 patients seemed to have some cognitive decline, as well.
Conclusions: The results suggest that the VLOSLP patients present stable cognitive and everyday functioning, as compared with chronically institutionalized elderly patients with schizophrenia.
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Background: Very late-onset schizophrenia-like psychosis (VLOSLP) is a psychotic disorder with an age of onset ≥60 years, and social isolation is a risk factor. Reports on the impact of interventions for isolation and loneliness on psychiatric symptoms in VLOSLP are limited.
Case Presentation: An 87-year-old woman, widowed and living alone, developed psychosis, including paranoia, erotomania, and visual hallucinations, at 84 years old during a period when her interactions with others were limited by the COVID-19 pandemic and osteoarthritis.
[Late-onset schizophrenia and schizophrenia-like psychosis with very late onset].
Zh Nevrol Psikhiatr Im S S Korsakova
August 2024
Mental Health Research Center, Moscow, Russia.
Article Synopsis
- - The review examines late-onset schizophrenia and very late-onset schizophrenia-like psychosis (VLOSLP), emphasizing their psychological, cognitive, and biological aspects, as well as the lack of research focused on these conditions compared to early-onset schizophrenia and other mental health issues in older adults.
- - Research findings were sourced from multiple databases, highlighting a significant gap in understanding late-onset schizophrenia, particularly regarding diagnosis, treatment, and the unique challenges faced by older patients.
- - The study advocates for a comprehensive treatment approach that includes medication, psychotherapy, and the involvement of caregivers, while also stressing the need to evaluate the risks and benefits of pharmacological treatments in elderly patients.
A Bird's-Eye Perspective: An Unusual Case of Very Late-Onset Schizophrenia-Like Psychosis With Visual Hallucinations Included in Its Manifestations Versus the Dementia Prodrome.
Cureus
April 2024
Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Very late-onset schizophrenia-like psychosis (VLOSLP) is still a paradox; certain characteristics such as episodic progression of psychosis including delusions and hallucinations involving various modalities, as well as the absence of negative symptoms, are strongly predictive of VLOSLP. We describe an interesting case of a 61-year-old male who presented with a second episode of psychosis along with mild to moderate cognitive impairment like having difficulty in buttoning for over eight months at our tertiary care hospital. Previously, during the first episode, he was treated by a private practitioner; adequate doses for an adequate duration of two atypical antipsychotics were given; and up to 25% global improvement was reported by the caregiver.
View Article and Find Full Text PDFMirtazapine Monotherapy for Antipsychotics-refractory Psychosis in a Patient with Very-late-onset Schizophrenia-like Psychosis: A Case Report.
Clin Psychopharmacol Neurosci
May 2024
Department of Psychiatry, Takatsuki Hospital, Hachiouji, Japan.
Very-late-onset schizophrenia-like psychosis (VLOSLP) is a condition in which psychotic symptoms emerge after the age of 60 years. Given its heterogeneous nature, VLOSLP remains a diagnostic and therapeutic dilemma. Here, we report a case of a 68-year-old patient with psychosis refractory to antipsychotics who was successfully treated with mirtazapine monotherapy.
View Article and Find Full Text PDFA voxel- and source-based morphometry analysis of grey matter volume differences in very-late-onset schizophrenia-like psychosis.
Psychol Med
February 2024
Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium.
Background: Very-late-onset schizophrenia-like psychosis (VLOSLP) is associated with significant burden. Its clinical importance is increasing as the global population of older adults rises, yet owing to limited research in this population, the neurobiological underpinnings of VLOSP remain insufficiently clarified. Here we address this knowledge gap using novel morphometry techniques to investigate grey matter volume (GMV) differences between VLOSLP and healthy older adults, and their correlations with neuropsychological scores.
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