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Late Onset Schizophrenia. A Case Report

Published online by Cambridge University Press:  23 March 2020

J.M. Hernández Sánchez*
Affiliation:
Valencia, SpainValencia, Spain
M.C. Cancino Botello
Affiliation:
Hospital General de Valencia, Psychiatry, Valencia, Spain
M.F. Molina Lopez
Affiliation:
Hospital General de Valencia, Psychiatry, Valencia, Spain
M. Muñoz Carril
Affiliation:
Hospital General de Valencia, Emergency Medicine, Valencia, Spain
S. Arnés González
Affiliation:
Hospital General de Valencia, Emergency Medicine, Valencia, Spain
J.A. Monzó
Affiliation:
Hospital General de Valencia, Internal Medicine, Valencia, Spain
*
*Corresponding author.

Abstract

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Introduction

The presence of elderly people is more and more common in developed countries. Unlike other medical conditions, late onset psychosis includes organic and mental precipitants in its differential diagnosis.

Objectives

To present a case of late onset schizophrenia.

Methods

Medline search and review of the clinical history and the related literature.

Results

We present the case of a 71-year-old woman with organic medical history of rectum adenocarcinoma in 2008 that underwent radiotherapy, chemotherapy and surgical resection with successful results. According to the psychiatric history, this patient has needed two admissions to the psychiatry ward, the first of them in 2012, (when the delusional symptoms started), due to deregulated behaviour in relation to persecutory delusions and auditory pseudo-hallucinations. In 2012, she was diagnosed with late onset schizophrenia. Blood tests (hemograme, biochemistry) and brain image were normal. Despite treatment with oral amisulpride and oral paliperidone and due to low compliance, delusional symptoms have remained. We started treatment with long-acting injectable papliperidone 75 mg/28 days having reached clinical stability.

Conclusions

Late onset psychosis is due to a wide range of clinical conditions. In this case, our patient had no organic precipitants. The evolution and presentation of delusional symptoms in this patient made us think of late onset schizophrenia as main diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV978
Copyright
Copyright © European Psychiatric Association 2016

References

Further reading

Colijn, MA,et al. Psychosis in later life: a review and update. Harv Rev Psychiatry 2015;23(5):354–67CrossRefGoogle ScholarPubMed
Reinhard, MM., Late-life psychosis: diagnosis and treatment. Curr Psychiatry Rep 2015;17(2):1CrossRefGoogle Scholar
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