Senile psychosis belongs to a group of diseases that people suffer in old age. Most often, senile or senile psychosis manifests itself in the form of depressive and paranoid states, dementia. In old age, a person’s mental activity becomes weaker, it becomes impoverished and disintegrates. This process is completely normal, it is characteristic of the body during aging, but at the same time, senile dementia is a pathological process.

Numerous studies have shown that senile dementia is more common among women than among men. If among the family members there were people suffering from senile dementia, then in this case there is a risk that the disease may manifest itself in other people who are relatives.

How does senile psychosis manifest?

With this disease, the patient’s individuality, characteristic of his character, disappears. Also, the patient’s level of judgment is reduced, the person is not able to learn anything, he does not acquire new skills, and memory fades. A person begins to forget at first the experience that he acquired recently, and after a while he forgets the experience that he received throughout his life.

The patient remembers something that has never happened to him, and his speech loses its verbosity and becomes scarce. Ultimately, there are only physical needs of an elementary nature. Against the background of dementia, states of a psychotic nature may alternate. These are depressions of an anxious or angry type, the occurrence of a delusional state, a feeling of jealousy, material damage. Such patients suffer from confusion of consciousness, which is combined with somatic diseases.

Patients with senile psychosis often experience depression. They are of average severity, but last for quite a long time. This condition is characterized by a person’s constant dissatisfaction, he is gloomy and irritated, and suffers from hypochondriacal diseases. In some cases, senile psychosis is significantly aggravated by the presence of somatic diseases in the patient. Typically, patients between the ages of seventy and eighty are susceptible to senile psychosis.

How is senile psychosis treated?

Treatment of senile psychosis is quite difficult, and, as a rule, specialists first prescribe symptomatic treatment. The therapeutic regimen is selected individually in each case. Such aspects as the nature of the course of senile psychosis and the presence of concomitant diseases, which may be a complicating factor, are taken into account.

But it should be emphasized that in our time there are no methods to get rid of senile dementia. Psychologists are engaged in a serious study of this problem, research is underway. In the treatment of senile psychosis, a significant place is given to symptomatic therapy, on which the main emphasis is placed.

If there is confusion or restless behavior, the doctor will prescribe medications that have a sedative effect. For example, sonapax, tizercin, in small doses. In case of a depressive state, the patient is indicated in small doses, simultaneously with sedatives, this,

Senile psychosis is a disease that affects older people and is caused by brain atrophy. But, of course, this does not mean that senile psychosis is inevitable for all older people. The development of senile psychoses is primarily due to genetic predisposition. As for external influences, they have only a provoking role. Sometimes they can intensify the process. Various clinical forms are mainly related to the predominant atrophy of certain areas of the cortex, atrophy of subcortical brain formations.

A common feature for senile psychoses can be considered their smooth course, when the disease develops slowly, but, nevertheless, constantly progresses. As a result, a deep breakdown of mental activity occurs, that is, total dementia. Senile psychoses have their own clearly defined signs. The main symptoms are considered to be a weakened ability to remember, difficult perception of external impressions. Also, the character of patients changes. This is expressed in emotional dullness, fussiness, pathological stinginess, and night restlessness is especially characteristic.

Senile psychosis has a chronic course, with periodic remissions and periods of exacerbation. The onset of the disease is always slow. Sometimes it has a stationary character for several years, but more rapid development is not excluded. With this disease, the thinking process becomes more and more disrupted over time, the personality becomes coarser, and individual properties become more prominent. Some patients become complacent and carefree, others behave viciously and lose their former affections. Some patients are deprived of basic moral principles. It is often believed that deterioration of character is a phenomenon characteristic of old age, but memory disorders are added to it.

Although scientists are discussing possible causes of senile psychosis, they have not yet been established with certainty. It is believed that, as with many other atrophic processes, in this case heredity plays a significant role. Moreover, there are well-known clinical cases of the so-called “familial dementia”. Basically, the onset of the disease occurs between the ages of sixty-five and seventy-five years. The average duration of the disease can be five years, while at the same time, there are cases when senile psychoses develop very slowly and can last ten years, and sometimes up to twenty.

Also, among the probable causes of the development of senile psychosis, experts name degenerative processes occurring in the brain. In some cases, patients experience senile melancholy, and for this type of disorder the occurrence of organic changes in the brain is uncharacteristic. Another feature of brain changes associated with old age are moments of self-poisoning, related to senile involution of the endocrine glands, as well as other organs. Some experts argue that senile psychosis can manifest itself under the influence of various infectious diseases.

It is difficult to recognize atrophic processes in the brain in the initial stages of the disease; in this case, it is necessary to exclude possible vascular pathology, brain tumors, and other diseases. If there is a pronounced clinical picture of the disease, then diagnosing senile psychoses is not difficult. Also, to confirm the diagnosis, the doctor prescribes one of the modern examination methods, in this case it is computed tomography.

Despite the fact that certain drugs and techniques are used to treat senile psychosis, there are no effective measures. However, it has been established that for such patients the prescription of symptomatic drugs that affect individual signs of the disease is of great importance. It is also important to provide the patient with proper care. At the very beginning of the disease, it is better if the patient is kept at home so that there are no sudden changes in the usual rhythm of life. Often, placement in a medical institution causes a deterioration in the patient’s condition. It is best to create conditions for the patient so that his lifestyle is more active. That is, more movement, less lying down during the day. You can do your usual household chores.

If there is severe dementia, and at the same time, there is no possibility of appropriate care for the patient at home, then hospital treatment is recommended; there are also special boarding schools. Psychotropic drugs are prescribed only if sleep is disturbed, there are hallucinatory disorders, or sleep disorders. Basically, preference is given to those drugs that do not cause lethargy, weakness, and do not have complications or any side effects. Tranquilizers for the treatment of senile psychosis are recommended at night. Each drug is prescribed in a minimum dose to avoid unwanted reactions. Treatment with metabolic agents is only applicable if the disease is at an early stage, since in this case the process is stabilized to some extent.

Senile psychosis refers to a whole group of diseases characteristic of people over sixty years of age, whose mental activity is gradually impaired. Manifestations of pathology include senile dementia, late-onset depression and paranoid disorders. The main symptoms of the disease include states of confusion and various endomorphic disorders. At the same time, total dementia does not develop in patients. Presenile psychoses are characterized by a similar course, the onset of development of which usually occurs at the age of forty-five to sixty years. Most often, the pathology occurs in the form of involutional melancholy, that is, depression, or involutional paranoid, that is, bird disorder. Much less common are special malignant types of the disease, characterized by anxiety, confusion, and speech disorders.

Main reasons

The etiology of the development of presenile and senile psychoses still remains unknown. It is believed that the trigger point in the development of the disease can be a traumatic brain injury, other somatic pathologies, as well as any traumatic circumstances.

Senile psychoses occur as a result of brain atrophy, which is most often caused by hereditary factors. Cases of “familial dementia” have been encountered more than once in medical practice. Unfavorable external influences and somatic pathologies can aggravate the pathological process. And although the process of destruction of a person’s mental activity due to aging is absolutely natural, senile psychosis is generally considered a pathological condition.

Regarding the prevalence of the disease, numerous studies have revealed that senile and presenile psychoses are much more common among women than among the male population.

Clinical picture

If presenile psychosis occurs in the form of involutional melancholy, it is characterized by increased anxiety, delusional ideas of a predominantly hypochondriacal nature, accompanied by self-deprecation, a general depressed mood, and suicidal tendencies. Most often, patients experience prolonged depression.

Involutional paranoids are characterized by concreteness. Patients may experience delusions of jealousy, persecution, damage, etc. As a rule, with such disorders, those closest to the patient suffer: neighbors, relatives, since they are the ones accused of intentionally causing harm, theft of property, etc. Similar symptoms are characteristic of senile psychoses.

Senile psychoses can occur in both acute and chronic forms. Acute forms, characterized by confusion, often arise against the background of certain somatic pathologies: diseases of the cardiovascular system, respiratory tract, genitourinary area, etc. In fact, acute senile psychoses are symptomatic mental disorders. Symptoms of confusion in senile psychoses usually include motor agitation, fussiness, and lack of coordinated actions. Delusional disorders may also occur, accompanied by anxiety, hallucinations, and unreasonable fears. An acute attack of illness can last up to several weeks. The disease can occur continuously or in the form of periodic relapses.

Chronic senile psychosis can occur in the form of depressive or paranoid states. Depression in a mild form usually manifests itself as a feeling of internal emptiness, a pessimistic mood, lethargy, apathy, and loss of interest in previously favorite activities. The patient may experience a feeling of disgust towards everything around him. Hypochondriacal disorders often appear. In some cases, patients experience so-called “silent” depression, in which a person expresses virtually no complaints about his mental anxiety. Such states are usually referred to as late involutional melancholia.

Sometimes senile psychoses manifest themselves as chronic paranoid interpretive delusions. It seems to patients that those around them are trying to get rid of them by all means and are deliberately damaging their property, stealing personal belongings, intending to poison them, etc. Delusional behavior begins to manifest itself at the very beginning of the development of the disease. The patient may lock his room so that no one can enter it, complain to all sorts of authorities, and even strive to change his place of residence. The gradual reduction of delusional disorders can continue for many years, while the patient’s social adaptation practically does not suffer, as well as his ability to care for himself.

Additional symptoms

Other symptoms that may accompany senile psychosis are various types of hallucinations:

• Verbal hallucinosis Bonnet. Verbal hallucinations, in which the patient can hear threats and swearing at himself. The long course of this disorder contributes to the development of anxiety and motor restlessness in patients;
• Bonnet visual hallucinosis. This disorder always occurs acutely and develops according to certain scenarios. Gradually, single planar hallucinations turn into scene-like hallucinations, and the patient himself watches with interest what is happening. A person may try to enter into a dialogue with the images they see; in other cases, patients experience fear and try to drive away the vision. Over time, visual hallucinosis decreases, while dysmnestic disorders increase;
• Tactile hallucinosis. This is the so-called dermatosus delirium, in which patients feel constant skin itching, as if they were being bitten by invisible insects. This disorder is often accompanied by hypochondriacal delusions, as well as visual hallucinations in the form of peeling skin or insect bites.

Hallucinations in senile psychoses can last for ten to fifteen years, while the clinical picture is even more complicated if the patient has paranoid delusions. Often at the age of seventy or eighty years, the course of the disease changes somewhat. Dysmnesia may develop in the absence of signs of total dementia. Fifteen to seventeen years after the onset of the disease, significant memory deterioration is possible.

Almost all forms of chronic senile psychoses are characterized by the following general symptoms:

• manifestation of any one syndrome: either paranoid or depressive;
• the severity of mental disorders, on the basis of which a specialist can accurately classify the disease;
• preservation of intelligence and memory over a long period of time;
• if memory impairments occur, they are most often presented in the form of dysmnestic disorders;
• in the absence of serious vascular pathologies of the brain, people suffering from senile psychosis are able to maintain normal activity.

Diagnosis and differential diagnosis

It is possible to accurately diagnose presenile psychoses only when the disease first appears in the involution phase. At the same time, the symptoms of the disease are quite difficult to differentiate from bipolar disorder and late-onset schizophrenia. Differential diagnosis can be greatly facilitated if patients at involutional age do not have any signs of senile dementia or atherosclerosis.

Senile psychosis, which occurs due to atrophic processes in the brain, can be recognized quite easily in the initial stages, excluding oncological and vascular diseases, as well as other pathologies. The diagnosis is made based on existing clinical signs, as well as the results of additional research methods, for example, computed tomography.

There is no effective treatment for brain atrophy in older people. Presenile and senile psychoses require certain supportive therapy and symptomatic treatment to improve the quality of life of patients. It is recommended that such people, as far as possible, create all the conditions so that they can lead a more or less full life and provide proper care. To correct the general condition, medications from the group of tranquilizers and psychotropic drugs can be prescribed. If the course of senile psychosis is very severe, and there is no possibility of providing constant care for the patient, he must be placed in a hospital or a special boarding school.

– a group of psychotic conditions that occur in people over 60 years of age and are not accompanied by the rapid development of profound dementia. They vary in etiology and symptoms and can be acute or chronic. They manifest themselves as confusion, disturbances reminiscent of the clinical picture of schizophrenia or bipolar affective disorder. Paranoid, hallucinatory and hallucinatory-delusional states are possible. Diagnosed by a psychiatrist based on anamnesis, interviews with the patient and his relatives. Treatment includes antipsychotics, tranquilizers, nootropics, and therapy for concomitant somatic pathologies.

General information

Senile (senile) psychoses are mental disorders that first arise in old age and are largely functional in nature. They were first described and classified at the end of the 19th century by the German psychiatrist K. Fürstner and his colleagues J. Segla and A. Ritti. Then interest in the study of this group of disorders decreased; many researchers considered senile psychoses as psychotic variants of senile dementia. In the 40s of the twentieth century, the German psychiatrist W. Mayer-Gross and other specialists began to successfully treat such conditions. This, as well as the increase in average life expectancy and, accordingly, the number of patients, led to a revival of psychiatrists' interest in senile psychoses. The exact prevalence is unknown; according to various sources, the share of nosology in the general structure of mental illnesses of late age ranges from 12 to 25%. The age of onset of symptoms and gender distribution depend on the form of the disorder.

Causes of senile psychoses

Etiology and pathogenesis have not been established. It is assumed that the cause of the development of the disorder is an age-related weakening of mental activity against the background of certain personal characteristics, the influence of exogenous and endogenous unfavorable factors. Circumstances that increase the likelihood of senile psychosis include:

• Female gender. The ratio of men and women suffering from various forms of the disease varies significantly, however, in general, there is a predominance of female patients, especially among patients with depressive disorders.
• Hereditary predisposition. According to experts, senile psychoses are more often diagnosed in patients whose families have had cases of similar psychotic conditions or senile dementia.
• Somatic diseases. Exacerbations of therapeutic pathology provoke acute psychoses, existing diseases aggravate and modify the picture of chronic psychotic conditions.

Classification

The modern classification of senile psychotic conditions has existed since 1958, developed by a special WHO commission as part of the classification of mental disorders of late age, and compiled on a syndromic principle. Includes diseases with a predominantly functional component (as opposed to senile dementia, in which the organic component predominates), including:

• Affective psychoses. Manic and depressive disorders that first appeared in old age.
• Paraphrenia. Psychotic conditions, the defining symptoms of which are hallucinations, hallucinatory-delusional and delusional disorders.
• States of Confusion. Disorders in which confusion plays a dominant role.
• Psychoses in somatic diseases. They occur during exacerbation or decompensation of an existing therapeutic pathology.

There is also a Russian clinical classification, according to which there is one form of acute senile disorder (somatogenic or symptomatic psychosis) and five forms of chronic psychotic state: senile depression, hallucinosis, hallucinatory-paranoid and paranoid psychoses, senile paraphrenia. Experts note that, along with pathological conditions characteristic only of old age, this group of disorders includes forms similar to presenile psychoses (involutional depression and involutional paranoid). Some Russian psychiatrists consider these forms as late-onset variants of presenile disorders.

Symptoms of senile psychoses

Acute forms of senile psychoses. They are the most common. They usually occur against the background of decompensation or exacerbation of a somatic disease, therefore they are called somatogenic or symptomatic. Most often, the provoking factor is heart failure, acute or chronic pathologies of the respiratory tract, diseases of the genitourinary organs and hypovitaminosis. They are characterized by disturbances in orientation, fragmented symptoms, and frequent changes in forms of confusion. Possible motor agitation, anxiety, confusion, delusions, and mild hallucinations. Disorders last from several days to several weeks, can be one-time or multiple, the intensity of mental disorders directly correlates with the severity of somatic pathology. The outcome is a persistent or transient psychoorganic syndrome, asthenia, adynamia.

Chronic senile depression. Develops predominantly in women. They occur in the form of apathy, adynamia, or “silent” depressive states with severe affective disturbances (up to suicide, unexpected for relatives, against the background of outwardly mildly expressed mood changes). Possible hypochondriacal disorders, agitated states with self-blame, anxiety, and in severe cases - with the development of Cotard's delirium. The duration of the disease can be 10 years or more. In recent years, there has been a softening of the clinical picture; severe depression with delirium and agitation is less common. The pathology has a slight effect on the level of intelligence and cognitive functions; over time, mild memory impairment occurs.

Chronic paranoid psychoses. They manifest themselves as delusions of small scope - interpretative delusions about harmful intentions and actions on the part of relatives and neighbors. Patients believe that other people are trying to hasten their death, try to force them out of the apartment, secretly add poison or something inedible to their food, steal and rearrange things. Accompanied by attempts to “protect oneself” (changing locks, complaints to official authorities). They have little effect on social adaptation; the possibility of self-service is preserved. They last for years with a gradual reduction of symptoms.

Chronic hallucinosis. Occurs over the age of 70-80 years. They manifest themselves as visual, auditory (Bonnet hallucinosis) or tactile hallucinations. For visual and auditory hallucinosis, it is typical to maintain a critical attitude in combination with reactions to hallucinations as to real phenomena at the height of the attack. The average age of onset of symptoms of verbal hallucinosis is 70 years, visual - 80 years. Subsequently, patients develop dysmnestic disorders.

Hallucinatory-paranoid psychoses. They are characterized by the emergence of delusions of harm, which are later joined by hallucinations, which gradually acquire fantastic content and are subsequently replaced by confabulations. The first symptoms appear at the age of about 60 years, the clinical picture is initially similar to paranoid senile psychosis. At the age of 70-80 years, the symptoms are supplemented by polyvocal verbal hallucinosis, which resembles Bonnet hallucinosis, sometimes supplemented by echo thoughts, a feeling of mental openness, and mental voices. A schizophrenia-like picture of the disease develops. The outcome is paraphrenic-confabulatory disorders or ecmnestic confabulations. The duration of the course can be tens of years; over time, slowly progressive memory impairments are revealed.

Senile paraphrenia. Usually occurs after age 70. The leading place in the clinical picture is occupied by confabulations of fantastic content related to the past, sometimes combined with everyday confabulations. Patients talk about incredible, fascinating events that allegedly happened to them, about friendships with celebrities, about victories in love, etc. Confabulations are persistent in nature, changes both in the basis of the plot and in details are uncharacteristic. Typically euphorically elevated mood, possible development of delusions of grandeur. The duration of the course is 3-4 years; subsequently, a gradual reduction of symptoms is observed with the development of dysmnestic disorders.

Diagnostics

A senile psychotic state is diagnosed taking into account the patient’s age and the clinical picture of the disease. Characteristic features are:

• Stability, limited manifestations. Symptoms change little over time, usually limited to disorders of one circle, often to one syndrome (with the exception of the hallucinatory-paranoid form, in which standard changes in clinical symptoms are observed).
• Severity of disorders. Psychopathological manifestations in senile psychoses are usually pronounced enough to accurately identify a psychotic state and determine its type.
• Duration of productive disturbances. Delusions and hallucinations in senile psychoses persist stably for a long period of time (several years), and then gradually decrease.
• Preservation of intelligence. There are no gross impairments of cognitive functions; a gradual increase in dysmnestic disorders with long-term preservation of emotionally charged memories is characteristic.

Differential diagnosis of senile psychoses is carried out with depression with late manifestation of bipolar disorder, late schizophrenia, paranoid disorders that occur in the initial stages of senile dementia. Chronic verbal hallucinosis is differentiated from rare hallucinatory disorders in vascular pathology of the brain; paraphrenia is differentiated from presbyophrenia. If a somatic pathology is suspected, appropriate diagnostic studies are performed, for example, CT and MRI of the brain.

Treatment of senile psychoses

The basis of treatment is drug therapy. Patients are prescribed antipsychotics, antidepressants, and sedatives. When selecting a drug and determining the dosage, age-related changes in the reaction to the action of medications and an increase in the likelihood of side effects are taken into account. The treatment program must be supplemented with nootropics. At the same time, they treat somatic diseases, correct the general condition of the patient, and provide careful care.

Prognosis and prevention

The prognosis for timely treatment of acute senile psychosis is favorable; with a late start of treatment and severe symptoms, the outcome is the formation of a psychoorganic syndrome. Chronic forms of senile disorders of the psychotic level are considered as prognostically unfavorable in terms of recovery. Remission during treatment is sometimes observed in Bonnet hallucinosis and senile depression; in other disorders, a decrease in the intensity of the manifestations of the disease is possible. There is no specific prevention. Non-specific preventive measures include maintaining mental hygiene, avoiding stress, timely treatment of somatic diseases and early contact with a psychiatrist when signs of mental disorders appear.

Senile psychosis is a fairly common pathological disorder caused by brain atrophy. Usually overtakes a person in old age. Of course, not all older people suffer from senile psychosis; this pathology does not occur very often, but it does occur. The onset of the disease usually occurs at the age of 65-75 years. It is during this period that the first symptoms appear, to which the elderly person’s loved ones should pay attention and show the patient to a doctor.

Although the underlying causes are still not understood, scientists associate this pathology with heredity, as well as other atrophic processes in the brain. Moreover, cases of so-called familial dementia are well known, clearly traced and studied. In addition to the hereditary factor, experts associate the development of senile dementia with various chronic (acute) diseases, long-term sleep disturbances, hearing loss, and vision loss. Physical inactivity, loneliness and lack of adequate nutrition are also cited as reasons. How does senile psychosis develop, what are the symptoms and treatment of this disease? Let's talk about this in more detail:

Symptoms of senile psychosis

Let us immediately note that medicine distinguishes between acute forms of psychosis, manifested by a state of stupefaction, as well as chronic forms, characterized by hallucinatory, depressive, and other characteristic conditions.

All senile psychoses have one common feature - they develop slowly over a long period of time. But, despite their smooth course, they are constantly progressing. The result of this is an irreparable breakdown of the psyche, namely senile dementia.

With the development of pathology, senile psychoses begin to manifest themselves with obvious symptoms that cannot be ignored. The main ones include: pathological stinginess, emotional dullness, as well as excessive fussiness, constant night restlessness. Patients have an inability to remember, weakness in perception, and difficulties in perceiving the world around them. The character of patients gradually deteriorates.

In a chronic course, which occurs very often, periods of remission are replaced by periods of exacerbations. At the beginning of the disease, when it develops slowly and smoothly, the symptoms and signs are not clearly expressed, but they already attract attention. Although sometimes the disease develops rapidly from the very beginning.

Over time, the thinking process is increasingly destroyed, a strong change in personality occurs towards coarsening and simplification. Individual characteristics of a person become more superficial and schematic.

In some patients this is expressed in complacency and carelessness. Others become suspicious and embittered. Patients lose family ties and former attachments disappear. In some patients, elementary moral principles and attitudes disappear.

Many people consider deterioration of character to be a natural phenomenon of old age. But if your character changes radically, your personal qualities are erased, or a memory disorder appears, you should consult a doctor.

How to remove senile psychosis? Treatment

Since this pathology develops slowly, it is quite difficult to recognize the atrophic processes of the brain at the first stage, since the disease can be masked behind the symptoms of vascular, tumor and other diseases, which, as a rule, are always sufficient in older people.

For an accurate diagnosis, the patient is prescribed a series of examinations, for example, a computed tomography scan, which helps the doctor make an accurate diagnosis. If the symptoms of psychosis are pronounced, then diagnosis is not difficult.

Unfortunately, there is no special treatment for this particular disease. Symptomatic treatment is usually carried out, aimed at stopping the development of the disease and alleviating symptoms. The patient is also given special care.

At the onset of the disease, the patient is treated on an outpatient basis, in a familiar home environment. At the same time, relatives should help the patient, activate him, and diversify his life. This means more movement, less lying on the couch. Do not protect the patient from his usual household chores.

If the disease is pronounced, especially aggression or dementia, the patient is placed in a hospital or a special boarding school.

Drug treatment of senile psychosis

When senile psychosis symptoms are diagnosed and the treatment of which we are discussing today, the patient is prescribed certain medications to improve the condition and reduce the intensity of manifestations.

In the early stages, the patient receives treatment with metabolic agents that stabilize his condition.

In case of disturbances, severe sleep disorders, hallucinations, delusional states, psychotropic drugs are prescribed. Tranquilizers are used at night. Prescribed drugs that affect cerebral circulation. Usually, drugs are selected that do not cause lethargy, weakness, and have a minimum of contraindications and side effects. In addition, all drugs are prescribed in minimal doses to avoid unwanted reactions. Social therapy and psychotherapy play an important role.

It should be noted that prevention of senile psychosis is impossible. However, timely treatment of internal diseases, ensuring a positive psychological attitude, and attentive attitude from loved ones significantly reduces the risk of developing this disease in older people. Be healthy!