17 - 19 All individuals in the census register were consecutively (after date of birth) given a number from 1 to 5 or 11 to 15. 15, 16 We examined the prevalence of psychotic symptoms and paranoid ideation in relation to psychosocial risk factors, psychiatric and somatic disorders, sensory impairments, cognitive and daily living functioning, mortality rate, development of dementia, and symptom stability over time in a representative sample of nondemented subjects aged 85 years using information from psychiatric examinations, key-informant interviews, and medical records.įrom January 1, 1986, through December 31, 1987, all individuals born July 1, 1901, to June 30, 1902, and registered for census purposes in Göteborg, Sweden (N = 1502, living in the community or in institutions), were invited to participate in a health survey, the Longitudinal Gerontological and Geriatric Population Study (project leader for 1971-1987, Alvar Svanborg, MD, PhD for1988, Bertil Steen, MD, PhD). Studies of demented individuals report that information from caregivers yields higher rates of psychopathology than do the results of clinical examinations alone. 14 Thus, it is necessary to collect information from collateral sources, eg, key informants and medical records, to obtain more accurate estimates. 12, 13 It has been suggested that this prevalence is underrated because the elderly persons may be reluctant to report psychotic symptoms. POPULATION studies reporting psychotic symptoms and paranoid ideation in elderly persons indicate a low prevalence of these symptoms, 1 - 11 although frequencies may be higher in the very old. Hallucinations and paranoid ideation were associated with increased 3-year mortality in women but not in men.Ĭonclusions We found a higher prevalence of psychotic symptoms and paranoid ideation in the elderly than previously reported, and these symptoms were associated with a poor prognosis. Hallucinations (OR, 3.1 95% CI, 1.4-6.8), delusions(OR, 2.9 95% CI, 1.2-6.9), and paranoid ideation (OR, 2.7 95% CI, 1.2-6.2) were each related to increased incidence of dementia from 85 to 88 years of age. Paranoid ideation was associated with visual deficits (OR, 3.6 95% CI, 1.2-10.5) and myocardial infarction(OR, 4.6 95% CI, 1.7-12.6). Delusions were associated with disability in daily life (OR, 4.9 95% CI, 1.8-13.3).
Stepwise logistic regression analyses showed that hallucinations were associated with major depressive syndrome (odds ratio, 3.9 95% CI, 1.3-11.9), disability in daily life (OR, 5.2 95% CI, 1.8-14.9), and visual deficits (OR, 3.4 95% CI, 1.0-11.1). The sample was observed for 3 years regarding psychotic symptoms, mortality, and incident dementia. Methods Psychotic symptoms, physical disorders, disability in daily life, and sensory impairments were assessed using results of psychiatric and physical examinations, key-informant interviews, and medical record reviews in a representative sample of nondemented individuals aged 85 years living in the community or in institutions in Göteborg, Sweden (n = 347). Shared Decision Making and Communicationīackground Psychotic symptoms are reported to be uncommon in the elderly, and may be underrated in traditional epidemiological studies.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.PIP in combination with comorbid MDD showed higher risk of LSA than subjects without PIP or MDD. In conclusion, PIP, especially "doubting spouse," was significantly associated with LSA. Major depressive disorder (MDD) in combination with PIP was associated with a higher risk of LSA (AOR, 15.39 95% confidence interval, 9.63-24.59) compared with subjects without MDD or PIP. Among PIP symptoms, "spouse was being unfaithful" showed the strongest association with LSA (adjusted odds ratio, 4.49 95% confidence interval, 2.95-6.85). The PIP group showed more than fivefold higher lifetime suicide attempt (LSA) rates and ninefold multiple attempt rates than the non-PIP group. The PIP group was younger with more divorced/widowed/separated and lower income than the non-PIP group. Among 12,532 subjects, 471 (3.76%) met criteria for the PIP group. Subjects completed a face-to-face interview. A total of 12,532 adults were randomly selected as the study sample through one-person-per-household method. This study aimed to characterize the association between paranoid ideation without psychosis (PIP) and suicide attempts in a general population.
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