Late‐life paranoia: Possible association with early trauma and infertility

We have collected data on 39 persons with late‐life onset of paranoid symptoms, all but two of whom are women. We identified a subset of nine patients that met the criteria for delusional disorder. This group differed significantly from both demented and long‐term schizophrenic patients on a number of variables. There was only one live birth among these nine women; more than half were refugees or holocaust survivors; there was an absence of a predicted sensory loss; and the manifestation of the paranoia was qualitatively different. Several issues are discussed: there is a late‐life delusional state that is neither schizophrenia nor dementia; the paranoia in these delusionally disordered patients cannot be accounted for exclusively by the social isolation hypothesis; there is an interaction among early trauma, the absence of children, and the appearance of paranoid ideation late in life.