Psychotic Disorders in the Elderly: Diagnosis, Epidemiology, and Treatment

Corinne E Fischer; Andrew Namasivayam; Lucas Crawford-Holland; Narek Hakobyan; Tom A Schweizer; David G Munoz; Bruce G Pollock

doi:10.1016/j.psc.2022.07.001

Psychotic Disorders in the Elderly: Diagnosis, Epidemiology, and Treatment

Psychiatr Clin North Am. 2022 Dec;45(4):691-705. doi: 10.1016/j.psc.2022.07.001. Epub 2022 Oct 14.

Authors

Corinne E Fischer¹, Andrew Namasivayam², Lucas Crawford-Holland³, Narek Hakobyan³, Tom A Schweizer⁴, David G Munoz⁵, Bruce G Pollock⁶

Affiliations

¹ Keenan Research Centre for Biomedical Science, Room 17044 cc wing, St. Michaels Hospital, #30 Bond St., Toronto, Ontario, M5B1W8, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Electronic address: corinne.fischer@unityhealth.to.
² Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
³ Keenan Research Centre for Biomedical Science, Room 17044 cc wing, St. Michaels Hospital, #30 Bond St., Toronto, Ontario, M5B1W8, Canada.
⁴ Keenan Research Centre for Biomedical Science, Room 17044 cc wing, St. Michaels Hospital, #30 Bond St., Toronto, Ontario, M5B1W8, Canada; St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Department of Neurosurgery, University of Toronto, Toronto, Canada.
⁵ Keenan Research Centre for Biomedical Science, Room 17044 cc wing, St. Michaels Hospital, #30 Bond St., Toronto, Ontario, M5B1W8, Canada; St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
⁶ Division of Geriatric Psychiatry, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada; Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada.

PMID: 36396273
DOI: 10.1016/j.psc.2022.07.001

Abstract

This review covers the latest advances in our understanding of psychosis in the elderly population with respect to diagnosis, epidemiology, and treatment. Major topics of discussion include late life psychiatric disorders such as schizophrenia, schizoaffective disorder, and delusional disorder as well as dementia-related psychosis. Clinical differences between early-onset and late-onset disorders are reviewed in terms of prevalence, symptomatology, and approach to treatment. Newly revised research and clinical criteria for dementia-related psychosis are referenced. The evidence base for emerging therapies including citalopram and pimavanserin in relation to conventional therapies such as atypical antipsychotics are discussed..

Keywords: Alzheimer disease; Citalopram; Delusional disorder; Elderly; Pimavanserin; Psychosis; Schizoaffective disorder; Schizophrenia.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antipsychotic Agents* / therapeutic use
Citalopram / therapeutic use
Dementia* / drug therapy
Humans
Psychotic Disorders* / diagnosis
Psychotic Disorders* / drug therapy
Psychotic Disorders* / epidemiology
Schizophrenia* / drug therapy

Substances

Antipsychotic Agents
Citalopram