Chronic late-onset schizophrenia-like psychosis that remitted: revisiting Newton's psychosis?

Abstract

According to historical records, Sir Isaac Newton developed new-onset psychosis at age 51, which was characterized by persecutory delusions. His psychotic symptoms remitted in less than 18 months, but their etiology has since remained a puzzle. The present case conference involves a present-day individual with late-onset paranoid psychosis with later remission, which has some interesting similarities to, as well as important differences front Newton's illness. Our patient had no history of psychiatric illness until age 52, when he developed paranoid delusions, which included thought broadcasting, auditory hallucinations, blunted affect, and poor insight. His early medical history was remarkable for grand mal seizures between ages 15 and 29. His psychosis improved with the use of antipsychotic medication. Approximately 6 years after its onset, his psychotic illness remitted, and all psychotropic medications were discontinued. Four years later, at the writing of this report, our patient continued to function independently with no psychiatric symptoms. We discuss the differential diagnosis for this chronic late-onset schizophrenia-like psychosis with remission.