Book contents
- Handbook of Old Age Liaison Psychiatry
- Handbook of Old Age Liaison Psychiatry
- Copyright page
- Contents
- Contributors
- Introduction
- Chapter 1 Psychological Well-Being in Later Life
- Chapter 2 The Epidemiology of Mental Illness in Older People in Acute Hospitals
- Chapter 3 Elderly-Friendly Care Settings and Hospitals
- Chapter 4 Communication with Older People
- Chapter 5 Privacy and Dignity in Acute Hospitals
- Chapter 6 Liaison Psychiatry and Law
- Chapter 7 Safeguarding Adults
- Chapter 8 Carers’ Needs before, during, and after Hospital Admissions
- Chapter 9 Dementia and Related Disorders
- Chapter 10 Behavioural and Psychological Symptoms of Dementia in Hospital Settings
- Chapter 11 Liaison Old Age Psychiatry Management of Delirium in Acute Hospitals
- Chapter 12 Depression and Associated Disorders
- Chapter 13 Prevention of Suicide and Self-Harm in Older People
- Chapter 14 Fear and Anxiety in Acute Settings
- Chapter 15 Late-Onset Psychosis and Related Disorders
- Chapter 16 Drug and Alcohol Misuse in Older People
- Chapter 17 Perioperative Medical Management of Older People
- Chapter 18 Parkinson’s Disease and Related Disorders in Acute Hospitals
- Chapter 19 Comprehensive Geriatric Assessment in Clinical Practice
- Chapter 20 Interface between Liaison Psychiatry Services for Older People and Wider Community Services
- Chapter 21 Psychometric Measures in Old Age Psychiatry
- Index
- References
Chapter 15 - Late-Onset Psychosis and Related Disorders
Published online by Cambridge University Press: 04 April 2024
Book contents
- Handbook of Old Age Liaison Psychiatry
- Handbook of Old Age Liaison Psychiatry
- Copyright page
- Contents
- Contributors
- Introduction
- Chapter 1 Psychological Well-Being in Later Life
- Chapter 2 The Epidemiology of Mental Illness in Older People in Acute Hospitals
- Chapter 3 Elderly-Friendly Care Settings and Hospitals
- Chapter 4 Communication with Older People
- Chapter 5 Privacy and Dignity in Acute Hospitals
- Chapter 6 Liaison Psychiatry and Law
- Chapter 7 Safeguarding Adults
- Chapter 8 Carers’ Needs before, during, and after Hospital Admissions
- Chapter 9 Dementia and Related Disorders
- Chapter 10 Behavioural and Psychological Symptoms of Dementia in Hospital Settings
- Chapter 11 Liaison Old Age Psychiatry Management of Delirium in Acute Hospitals
- Chapter 12 Depression and Associated Disorders
- Chapter 13 Prevention of Suicide and Self-Harm in Older People
- Chapter 14 Fear and Anxiety in Acute Settings
- Chapter 15 Late-Onset Psychosis and Related Disorders
- Chapter 16 Drug and Alcohol Misuse in Older People
- Chapter 17 Perioperative Medical Management of Older People
- Chapter 18 Parkinson’s Disease and Related Disorders in Acute Hospitals
- Chapter 19 Comprehensive Geriatric Assessment in Clinical Practice
- Chapter 20 Interface between Liaison Psychiatry Services for Older People and Wider Community Services
- Chapter 21 Psychometric Measures in Old Age Psychiatry
- Index
- References
Summary
Late-onset psychosis covers a range of diagnostic possibilities. Both underlying physical and psychiatric disorders may contribute to psychotic experiences. Psychiatrists have expertise in disentangling aetiological factors, assessing risk, and devising appropriate plans of care.
Causes of late-onset psychosis include very late onset schizophrenia-like psychosis (VLSOP), delusional disorder, affective disorder, dementia, and delirium. Early-onset schizophrenia may persist into later life and cause psychotic experiences. Physical factors that might contribute to hallucinations include hearing and visual deficits, medication toxicity, and alcohol.
The clustering of physical and psychosocial stressors in later life makes comprehensive geriatric assessment essential. Psychiatrists often call this holistic assessment ’the biopsychosocial approach’.
The use of the Mental Health Act to sanction involuntary treatment may be required if the risks warrant it.
Medication options for late-onset psychosis are limited by older people’s vulnerability to side effects. Much lower doses of antipsychotic drugs are required than for younger patients. Amisulpride has proven efficacy in VLOSP.
Keywords
- Type
- Chapter
- Information
- Handbook of Old Age Liaison Psychiatry , pp. 220 - 232Publisher: Cambridge University PressPrint publication year: 2024
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