DOI: 10.36347/sjams.2018.v06i10.007

Pages: 3700-3707

Delusions and paranoid ideation are common in the elderly, and they pose a diagnostic and clinical challenge. Delusional disorder accounts for1% of inpatient psychiatric hospital admissions. Female gender, sensory deficits, lower socioeconomic status, social isolation and immigrant status have been identified as risk factors. Among the various subtypes of delusional disorders, delusional parasitosis is seen more frequently in the elderly population, especially in females. There are well organized delusions, but no manifest perceptual disturbances, personality deterioration, or a formal thought disorder. To diagnose delusional disorder the clinician must rule out delirium, dementia, psychotic disorders due to general medical conditions or substance use, schizophrenia, mood disorders with psychotic feature. Atypical antipsychotics are the first-line treatment for older patients because of the improved side effect profile compared with conventional antipsychotics along with psychotherapy and supportive measures.