| Popis: |
The diagnostic category “schizophrenia spectrum and other psychotic disorders” comprises a group of conditions spanning both primary mental disorders and those secondary to other medical conditions. Within the population of older adults, the symptoms of psychosis are highly prevalent, etiologically heterogeneous, clinically diverse, and the sources of marked excess morbidity and mortality. Approximately 5–62% of elders, dependent on the population sampled, will experience newly incident psychosis. With the aging of our global population, the prevalence of psychotic disorders is only expected to rise—along with the attendant personal and social costs. Clinically, these conditions likely represent the manifestation of interactions between genetic, neurodevelopmental, neurophysiological aging, physical comorbidities, environmental, and social influences—with up to 60% of these cases attributable to other medical conditions. The inherent complexity and fragile nature of the geriatric patient with psychosis necessitate comprehensive assessment combined with a treatment approach that prioritizes non-pharmacological management. Antipsychotic medications, when necessary, should be used in combination with other treatment modalities, utilizing the smallest effective dosage, with attempts to further minimize dosing made at regular intervals. This chapter focuses its review on the epidemiology, pathophysiology, clinical presentation, and diagnosis of the primary psychotic disorders in older adults, including schizophrenia, schizoaffective disorder, and delusional disorder. |
