Geriatrics » Clinical evaluation of common complaints

Delusional Disorders In The Elderly

Delusional disorder often manifests as exaggerated and comprehensive mistrust and suspicion of the motives of other people, with increased alertness and observation. Patients may have one or more non-bizarre (i.e. involving situations that could occur in real life) delusion(s), present for at least 1 month, Auditory and visual hallucinations may be present but are not prominent, while tactile and olfactory hallucinations often are present if related to the delusional theme. Apart from the impact of the delusion, functioning is not impaired markedly, and behaviour is not obviously bizarre. Mood episodes that may have occurred are brief relative to the delusional periods. The disturbance is not due to the direct effects of a substance or a general medical condition. Antipsychotic drugs are start with the lowest possible dose in order to avoid side effects. The choice of drug for each individual patient should thus be based on considerations of concomitant physical illness and other treatments received.

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