Late-Onset Schizophrenia and Delusional Disorder

We compared 20 patients with late-onset schizophrenia, 7 with delusional disorder with halluci-nations (paraphrenia), and 13 with delusional disorder without hallucinations (late-onset para-noia). We found that these three categories could be distinguished from each other on some clinical parameters. Late-onset schizo-phrenia was characterized by bi-zarre delusions; auditory hal-lucinations; to a lesser degree, first-rank and negative symp-toms; and premorbid personality of the paranoid or schizoid type. Paraphrenia was associated with predominantly nonbizarre delu-sions, auditory hallucinations, earlier onset of symptoms, and paranoid or schizoid personality. Paranoia (late-onset) was charac-terized by late onset of symp-toms, nonbizarre delusions, relatively intact premorbid per-sonality, and an underlying physical stratum. Kraepelin (1919/1971) applied the diagnosis "paraphrenia " to schizo-phrenia patients who developed psychosis in later life 0este et al. 1991). Paraphrenic patients were characterized by delusions and hal-lucinations of a paranoid nature. Kraepelin introduced the term "paranoia " to describe a chronic illness characterized by well-organized delusions without hallu-cinations, formal thought disorder, or personality deterioration (Flint et al. 1991). Since Kraepelin's time, these two diagnostic categories have been poorly studied and their concep-tual boundaries blurred. ICD-