Strength, resilience, and diversity in psychotic spectrum disorders of late-life

Abstract

Approximately one in four people will develop psychosis in their lifetime. Late-life psychosis carries significant risks of isolation, caregiver distress, polypharmacy, and mortality. Unfortunately, there is a gap between the prevalence of psychotic disorders in older adults and the strategies available for assessment and intervention. There are scarce reliable pathognomonic signs to diagnose primary or secondary psychosis. Therefore, a comprehensive evaluation to establish the correct diagnosis is crucial for developing appropriate treatment. There is a consensus to categorize late-life psychosis as either primary or secondary psychosis. Primary psychoses include schizophrenia (early, late, or very late onset), affective psychosis, and delusional disorders. Secondary psychoses can be due to delirium, disease, drugs or dementia. Each condition would benefit from further diagnostic testing, psychosocial and environmental interventions, and judicious use of pharmacotherapy.This session will present an updated review of the assessment of psychotic spectrum disorders of late-life, as well as evidence-based psychosocial and pharmacological interventions. Dr. Michael will emphasize strength-based assessment and goals of care. Dr. Hashem will provide an overview of longitudinal trajectories and outcomes of late-life psychosis, as well as judicious use of pharmacotherapy when indicated. Dr. Kumar will review evidence-based psychosocial interventions in primary and secondary late-life psychotic disorders. Dr. Reinhardt will serve as a discussant and introduce the panel to the participants.