Paraphrenia is a late-onset mental disorder similar to schizophrenia in that it features the positive symptoms of the disease, such as delusions and/or hallucinations, but lacks the negative symptoms, such as the deterioration of intellect or personality.

Compared to schizophrenia, paraphrenia is less hereditary, has a slower rate of progression and doesn’t manifest until the patient is much older, with most patients developing the disorder around the age of 60 or older. Patients also seem more grounded and are better-oriented to time and space compared to patients with schizophrenia. Paraphrenia affects 2-4% of elderly people. While it occurs in both genders, it is more common in women.

Paraphrenia is not included in the DSM-5. More recently, clinicians have been classifying it as very late-onset schizophrenia-like psychosis. In fact, patients who present with these particular symptoms have been diagnosed with a variety of other illnesses, including atypical psychosis, schizoaffective disorder, delusional disorder or persistent persecutory state.

The hallucinations in paraphrenia are often auditory with approximately 75% of patients reporting such an experience. Visual, olfactory and tactile hallucinations have been reported as well.

Those who develop the disease in late life are often described as having eccentric and/or solitary personalities prior to the illness. Many are described as having been argumentative, overly-sensitive, overly religious, suspicious or cold.

It is very common for paraphrenia patients to experience delusions revolving around the idea of persecution. For example, a patient with this disease might believe that the police are staked out in his hedge at night waiting for him to come out, or be convinced that a neighbor is tapped into his phone line, listening to everything he says. Feelings of grandiose, hypochondriacal and erotic delusions have also been reported.

Example: Patricia had long been living alone before she developed full-blown psychosis. Her family members had been estranged for some time, and whenever they tried to contact her, she accused them of trying to steal her money.