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Personality structure in the paranoid psychoses of later life

Published online by Cambridge University Press:  16 April 2020

R Howard  and
R Levy
R Howard
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, DeCrespigny Park, Camberwell, London, SE5 8AF, UK
R Levy
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, DeCrespigny Park, Camberwell, London, SE5 8AF, UK
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Summary

Abnormal premorbid personality has long been considered to be an important feature of patients who develop schizophrenia, or schizophrenic-like psychoses late in life. Schizoid and paranoid personality traits in particular are repeatedly reported to have preceded the development of psychosis by many years. Such personality abnormalities have been viewed as part of a schizophrenic spectrum disorder, causally invoked in the aetiology of psychosis, or even regarded as an adaptive protection of vulnerable individuals against psychotic breakdown. An ICD-10 diagnosable personality disorder, however, is seen in only about 50% of patients who develop a paranoid psychosis late in life. The premorbid personality abnormalities encountered in late-onset paranoid states and delusional disorder are different from those reported in schizophrenia and there appears to be a genetic basis for these differences. The role of such personality disturbance in the aetiology of psychosis is controversial but probably only minor.

Keywords

premorbid personalitypersonality disorderlate-life paranoid states or late paraphrenialate-onset schizophrenia
Type
Review
Information
European Psychiatry , Volume 8 , Issue 2 , 1993 , pp. 59 - 66
Copyright
Copyright © Elsevier, Paris 1993

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References

Abrams, RC (1991) The ageing personality. Int J Geriatr Psychiatry 6, 1–3CrossRefGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders. 3rd edn revised. AMA, Washington DCGoogle Scholar
Casey, PRTyrer, Ρ (1990) Personality disorder and psychiatric illness in general practice. Br J Psychiatry 156, 261–265CrossRefGoogle ScholarPubMed
Castle, DHoward, R (1992) What do we know about the aetiology of late-onset schizophrenia? Psychiatry 7, 99–108Google Scholar
Cervantes, RCSalgado-Snyder, VN and Padilla, AM (1989) Post-traumatic stress in immigrants from Central America and Mexico. Hosp Commun Psychiatry 40, 615–619Google ScholarPubMed
Gurian, BSWexler, DBaker, EH (1992) Late-life paranoia: Possible association with early trauma and infertility. Int J Geriatr Psychiatry 7, 277–284CrossRefGoogle Scholar
Hamilton, M (1984) Fish's Schizophrenia. Wright LondonGoogle Scholar
Herbert, MEJacobson, S (1967) Late paraphrenia. Br J Psychiatry 113, 461–469CrossRefGoogle ScholarPubMed
Holden NL, (1987) Late paraphrenia of the paraphrenias? A descriptive study with a 10-year follow-up. Br J Psychiatry 150, 635–639CrossRefGoogle ScholarPubMed
Jaspers, K (1910) Delusions of jealousy. A contribution to the question “development of a personality or process”. Z Gesamte Neurol Psychiatrie 1, 567–582CrossRefGoogle Scholar
Kay, DWKCooper, AFGarside, RFRoth, M (1976) The differentiation of paranoid from affective psychoses by patients' premorbid characteristics. Br J Psychiatry 129, 207–215CrossRefGoogle ScholarPubMed
Kay, DWKRoth, M (1961) Environmental and hereditary factors in the schizophrenias of old age (“late paraphrenia”) and their bearing on the general problem of causation in schizophrenia. J Mental Sci 107, 649–686CrossRefGoogle Scholar
Kendler, KS (1980) The nosologic validity of paranoia (simple delusional disorder). Arch Gen Psychiatry 37, 699–706CrossRefGoogle ScholarPubMed
Kendler, RSHays, Ρ (1981) Paranoid psychosis (delusional disorder) and schizophrenia. A family history study. Arch of Gen Psychiatry 38, 547–551CrossRefGoogle ScholarPubMed
Kraepelin, E (1921) Manic Depressive Insanity and Paranoia. Translated by Barclay, RMLivingstone, EdinburghCrossRefGoogle Scholar
Kretschmer, E (1918) Sensitive Delusions of Reference. Springer, BerlinGoogle Scholar
Mann, AHJenkins, RCutting, JC and Cowen, PJ (1981) The development and use of a standardised assessment of abnormal personality. Psychol Med 11, 839–847CrossRefGoogle Scholar
Naguib, MLevy, R (1987) Late paraphrenia: neuropsychological impairment and structural brain abnormalities on computed tomography. Int J Geriatric Psychiatry 2, 83–90CrossRefGoogle Scholar
Parnas, JJorgensen, A (1989) Pre-morbid psychopathology in schizophrenia spectrum. Br J Psychiatry 155, 623–627CrossRefGoogle ScholarPubMed
Parnas J, Schulsinger, FSchulsinger, HMednick, STeasdale, Τ (1982) Behavioural precursors of the schizophrenia spectrum. Arch Gen Psychiatry 39, 658–664CrossRefGoogle ScholarPubMed
Pearlson, CDKreger, LRabins, PVChase, GACohen, BWirth, JBSchlaepfer, TBTune, LE (1989) A chart review study of late-onset and early-onset schizophrenia. Am J Psychiatry 146, 1568–1574Google ScholarPubMed
Pearlson, GRabins, Ρ (1988) The late onset psychoses: possible risk factors. Psychiatric Clinics of North America 11, 15–32CrossRefGoogle ScholarPubMed
Post, F (1966) Persistent Persecutory States of the Elderly. Pergamon Press, OxfordGoogle Scholar
Retterstol, N (1966) Paranoid and paranoiac psychoses. A personal follow-up investigation with special reference to aetiological, clinical and prognostic aspects. Oslo. Universitetsforlaget. Thomas, SpringfieldGoogle Scholar
Roth, M (1987) Late paraphrenia: phenomenology and aetiological factors and their bearing upon problems of the schizophrenic family of disorders.In: Schizophrenia and Ageing (Miller, NCohen, GL eds). Guilford Press, New YorkGoogle Scholar
Stangl, DΡfohl, BZimmerman, MBowers, WCorenthal, C (1985) A structured interview for the DSM III-R personality disorders. Arch Gen Psychiatry 42, 591–596CrossRefGoogle Scholar
Tyrer, PAlexander, JFerguson, B (1988) Personality Assessment Schedule.In: Personality Disorders: Diagnosis, Management and Course (Tyrer, P ed). London WrightGoogle Scholar
Tyrer, PAlexander, MSCicchetti, DCohen, MSRemington, M (1979) Reliability of a schedule for rating personality disorders. Br J Psychiatry 135, 168–174CrossRefGoogle ScholarPubMed
World Health Organisation (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9) WHO, GenevaGoogle Scholar
World Health Organisation(1989) Tenth Revision of the International Classification of Diseases (ICD-10) WHO GenevaGoogle Scholar
Zanarini, MCFrankenburg, FRChauncey, DL and Gunderson, JG (1987) The diagnostic interview for personality disorders: interrater and test-retest reliability. Comp Psychiatry 28, 467–480CrossRefGoogle ScholarPubMed
Zimmerman, MPfolhl, BCoryell, WStangl, DCorenthal, C (1988) Diagnosing personality disorder in depressed patients. A comparison of patient and informant interviews. Arch Gen Psychiatry 45, 733–737CrossRefGoogle ScholarPubMed
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