Abstract
Psychosis can include schizophrenia, mood disorders with psychotic features, delusional disorder, active delirium, and neurodegenerative disorders accompanied by various psychotic symptoms. Late-onset psychosis requires careful intervention due to the greater associated risks of secondary psychosis; higher morbidity and mortality rates than early-onset psychosis; and complicated treatment considerations due to the higher incidence of adverse effects, even with the black box warning against antipsychotics. Pharmacological treatment, including antipsychotics, should be carefully initiated with the lowest dosage for short-term efficacy and monitoring of adverse side effects. Further research involving larger samples, more trials with different countries working in consortia, and unified operational definitions for diagnosis will help elaborate the clinical characteristics of late-onset psychosis and lead to the development of treatment approaches.
Highlights
The definition of psychosis encompasses the presence of delusions, hallucinations, or both, without insights into the condition of others, which are derived from the problem of reality testing [1,2]
Psychosis may cover diagnoses such as schizophrenia, mood disorder with psychotic features, delusional disorders, delirium of an active type, and neurodegenerative disorders accompanied by various psychotic symptoms
We will investigate the overall epidemiology, clinical characteristics, recent research findings on neuropsychological characteristics, and treatment approaches with the careful management of side effects with a general focus on late-onset psychosis and a more specific focus on late-onset schizophrenia such as psychosis
Summary
The definition of psychosis encompasses the presence of delusions, hallucinations, or both, without insights into the condition of others, which are derived from the problem of reality testing [1,2]. Late-onset psychosis requires careful intervention for several reasons, including higher risks of secondary psychosis in older adults, higher morbidity and mortality rates than early-onset psychosis, and complicated treatment considerations due to a higher incidence of adverse effects [3,4]. The clinical considerations of secondary psychosis in older adults are important for its preponderance, leading to 60% of the etiologies of late-onset psychosis. It is necessary to consider differential diagnoses, including neurodegenerative disorders, characterized by delirium and substance-induced psychosis, and the effects of prescribed medications and illicit drugs [5,6]. We will investigate the overall epidemiology, clinical characteristics, recent research findings on neuropsychological characteristics, and treatment approaches with the careful management of side effects with a general focus on late-onset psychosis and a more specific focus on late-onset schizophrenia such as psychosis. At the end of the discussion, we will outline a few suggestions for future research to investigate late-onset psychosis
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