Paraphrenia

Paraphrenia
Other namesParaphrenic syndrome
SpecialtyPsychiatry
SymptomsHallucinations, delusions, paranoia
Usual onset60 years old
DurationChronic
Differential diagnosisSchizophrenia, bipolar disorder, delusional disorder
MedicationAntipsychotics
PrognosisNormal life expectancy

Paraphrenia is a mental disorder characterized by an organized system of paranoid delusions with or without hallucinations (the positive symptoms of schizophrenia) and without deterioration of intellect or personality (its negative symptom).[1][2][3]

This disorder is also distinguished from schizophrenia by a lower hereditary occurrence, less premorbid maladjustment, and a slower rate of progression.[4] Onset of symptoms generally occurs later in life, near the age of 60.[2][5] The prevalence of the disorder among the elderly is between 0.1% and 4%.[1]

Paraphrenia is not included in the DSM-5; psychiatrists often diagnose patients presenting with paraphrenia as having atypical psychosis, delusional disorder, psychosis not otherwise specified, schizoaffective disorders, and persistent persecutory states of older adults.[4] Recently, mental health professionals have also been classifying paraphrenia as very late-onset schizophrenia-like psychosis.[4]

In the Russian psychiatric manuals, paraphrenia is the last stage of development of paranoid schizophrenia. "Systematized paraphrenia" (with systematized delusions, or delusions with complex logical structure) and "expansive-paranoid paraphrenia" (with expansive/grandiose delusions and persecutory delusions) are the variants of paranoid schizophrenia (F20.0).[6] Sometimes systematized paraphrenia can be seen with delusional disorder (F22.0).[6] The word is from Ancient Greek: παρά – beside, near + φρήν – intellect, mind.

  1. ^ a b Almeida, O. P., Howard, H. F., & Levy, R. (1992). Late paraphrenia: a review. International Journal of Geriatric Psychiatry, 7, 543-548.
  2. ^ a b Roth, M. (1955). The natural history of mental disorder in old age. The British Journal of Psychiatry, 101, 281-301
  3. ^ Roth, M. & Kay, D. W. K. (1998). Late paraphrenia: A variant of schizophrenia manifest in late life or an organic clinical syndrome? A review of recent evidence. International Journal of Geriatric Psychiatry, 13, 775-784
  4. ^ a b c Casanova, M. F. (2010). The pathology of paraphrenia. Current Psychiatry Reports, 12, 196-201.
  5. ^ Cite error: The named reference Almeida,1995 was invoked but never defined (see the help page).
  6. ^ a b Сметанников, П. Г. (2002). Психиатрия: Краткое руководство для врачей [Psychiatry: A Brief Guide for Physicians] (in Russian). Rostov-on-Don: Phoenix (Феникс). pp. 157, 165. ISBN 5-222-02133-5.