Paranoid psychosis in the elderly

Hospital records comprising 106 first admissions of patients aged 60 years or more diagnosed paranoid disorder were studied. Affective psychosis and dementia were excluded. The female/male ratio was 2:1. Symptomatology, treatment and diagnostic classification are presented. Seventy-five per cent revealed persecutory delusions, and nearly half were hallucinated. Almost all patients received neuroleptics. The majority were diagnosed paranoid psychosis or reactive psychosis. After 5-15 years of observation a full remission was seen in 27% according to the judgement of general practitioners as well as hospital records. Delusions such as megalomania and delusions with ideas of sex and jealousy showed a significantly poor outcome. The diagnosis reactive psychosis predicts a course of illness characterized by few relapses.