| Late paraphrenia is a term used to designate a condition which is specific to the elderly. Its criteria are believed to be an onset after the age of 55, paranoid delusions (usually circumscribed), and suspiciousness. Its risk factors are believed to be social isolation, hearing impairment and female sex. Paraphrenics often hallucinate, have visual impairments, and are violent. Current DSM III-R criteria have been revised to allow the inclusion of this group in the category of paranoid schizophrenia. However, the literature on paraphrenia suggests that this patient group may have too many idiosyncrasies to fit into any current diagnostic category easily. Paranoia in the elderly can occur in senile dementia, vitamin deficiencies, substance abuse, and certain medication regimens, as well as in paranoid schizophrenia and paranoid disorder. The diagnosis of paraphrenia is usually made upon exclusion of these other conditions, but whether this should be the case is currently unclear.;Since paranoia cannot be diagnosed as any type of mental illness if it is due to an organic brain disorder, this study proposed to compare symptoms of paraphrenia with those of the most common organic brain disorder in the elderly--Alzheimer's Dementia (AD). Specifically, this study hypothesized that the most important symptoms of each syndrome, paranoid delusions and cognitive impairment, are basically different in the two syndromes. In addition, the presence and awareness of hearing impairment, as well as the degree of social isolation, was investigated.;It was found that paraphrenic subjects had mild cognitive impairments relative to normals. There was some similarity to the pattern of cognitive deficits seen in early AD, but the two were not identical. It was also found that paraphrenics and AD patients did not have different types of delusions, though they did differ in the types of hallucinations and unusual ideas they expressed. Finally, paraphrenics were not found to be more socially isolated than normals or AD patients, though the increased prevalence of mental illness found in their families may have exposed them to more abnormal social backgrounds. Examination of hearing status was inconclusive, since all patients refused to undergo audiometric assessment. |
