Aim: This study explores the intricate relationship between social interactions and the development of persecutory delusions among older women living alone in Japan. Focusing on the unique perspective of individuals experiencing delusions outside clinical settings, the aim was to understand the impact of interpersonal interactions on delusion formation.

Methods: Cases of older women living alone with persecutory delusions were selected from records of municipal psychogeriatric services and medical consultations within a community space. This study employed a descriptive approach to propose a hypothesis regarding the possible connection between social interactions and the development of persecutory delusions within this demographic.

Results: Two relevant cases were identified, from which a three-step hypothesis emerged regarding the potential link between social interactions and the development of persecutory delusions in this demographic. Insights from these cases suggest that anxiety can trigger hallucinations, which, when unaddressed, evolve into delusional interpretations. Addressing these unmet needs could mitigate the progression of persecutory delusions.

Conclusions: The findings of this study underline the critical relationship between social interactions and persecutory delusions among older women living alone. The unmet need for empathy influences the progression from anxiety-driven hallucinations to fully formed delusions. Early intervention can prevent the escalation of delusions and involuntary psychiatric hospitalization. This study underscores the importance of recognizing the link between social isolation and delusion emergence. It advocates for compassionate environments to meet the psychological needs of older individuals grappling with delusions. Geriatr Gerontol Int 2024; 24: 118-122.

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http://dx.doi.org/10.1111/ggi.14699DOI Listing

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