Correlates of psychotic symptoms among elderly outpatients

Psychotic symptoms presenting in late life can offer a diagnostic challenge to the clinician. In this study, 140 geriatric outpatients were prospectiv ely examined for psychotic symptoms and assessed on a number of demographic and clinical variables. Cognition was assessed using the Mini-Mental State Exam. Psychiatric diagnoses were made by DSM-III-R criteria. Twenty-seven per cent (N = 38) had psychotic symptoms, delusions being the most common t ype. Patients with psychosis were significantly more likely to have a previ ous history of psychosis, to have a lower MMSE and to live in a nursing hom e. Four diagnoses accounted for 79.5% of all psychotic patients. In order o f frequency. these were dementia, major depression, delirium and organic ps ychosis (organic hallucinosis, organic delusional disorder). Psychotic pati ents were significantly more likely to have a diagnosis of dementia, deliri um or organic psychosis than non-psychotics, but depression was significant ly more likely to occur in patients without psychosis, Although psychotic s ymptoms occur in a variety of illnesses, elderly patients with psychosis sh ould be carefully evaluated for these disorders. (C) 1999 John Wiley & Sons , Ltd.