Paraphrenia and Persecutory Delusions: Brief Reflection about Neuropsychology Evaluation in the Elderly without Dementia

Abstract

Delusions are negative experiences and it can be vivid and clear, with all the power and impact of real or true perceptions. It may occur in any sensory modality, while auditory hallucinations are more common in schizophrenia and related disorders. The aim of this study was to describe the behavioral and cognitive profile of five cases of persecutory hallucination in elderly with no cognitive impairment. Case series study that analyze the characteristics, functional and cognitive abilities, of 5 patients older than 60 years, 4 to 9 years of schooling, with paranoid disorder. For the description of the personality, functionality and paranoid characteristics it were used structured interview of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) and the cognitive functions were applied by the Cambridge Cognitive Examination (CAMCOG). The assessment of the results was made through a qualitative and quantitative analysis of the instruments. Outcomes pointed to a preservation of functional and cognitive abilities, whereas delusions were persecutory and well elaborated. Neuroimaging was normal. Due to the cognitive preservation, lack of insight, several adjustments of the medication, for the duration and intensity of the delusions, the final diagnosis was paraphrenia. It can be concluded that it is necessary to continue following the five patients and to perform a new neuropsychological evaluation after one year of conduct.