What is the current status of Paraphrenia?

Question

First mentioned by Kalbhaum in 1863, and better known by Kraepelin's descriptions in 1912, paraphrenia seems to be forgotten after the publication of DSM-III. It is always described by its nosology, late onset, with very systematized delirium and typical theme, without losing too much contact with reality.

In general, it seems to have been fused with schizophrenia, persistent delirium, affective paraphrenia, and paranoid affection. Commonly described among delirium and schizophrenia.

ICD-10 includes it in F22 as a type of persistent delusional ideas, in ICD-9 included in paranoid states. It is not included in DSM-IV or DSM-V.

There are plenty descriptive studies, but few reviews with a focus on paraphrenia.

• Can anyone find a well-focused and detailed experimental review or trial?
• Do psychology / psychiatry associations claim it?
• Are there manuals that address it in diagnosis or didactically (not in general form but with detailed author)?
• Are there any authors especially focused on this disorder?

<sub>1. I am not interested in medication;
2. I am not interested in comorbidities such as paranoid affection (described as very characterized by a characteristic affection and there is some confusion with directly paranoid affection, affective paraphrenia).
3. I am not interested whether it appears to be closely related to paranoid schizophrenia (confusion due to systematized delirium).</sub>

Answer 1

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. It seems to be an outdated term (source: Psychology Central).

Can anyone find a well-focused and detailed experimental review or trial?

I have found a few, albeit all somewhat dated: Ravindran et al. (1999); Lubman & Castle (2002) and Sato & Idha, (2002). I can recommend to see whether these articles are cited in papers published on a later date if you prefer more recent literature.

Do psychology / psychiatry associations claim it?

Difficult question. The International Late-Onset Schizophrenia Group recognizes the disorder’s late-onset version as “very late-onset schizophrenia-like psychosis Howard et al. (2000). The CCI in Australia describes it. Smaller, more isolated institutions seem to recognize it, for instance, the Cardif & Vale Action for Mental Health at least acknowledges its existence. As you said, it appeared not in the DSM-IV and V manuals. Instead, more recently paraphrenia has been classified as

very late-onset schizophrenia-like psychosis

Patients who present these particular symptoms are generally diagnosed with a variety of other illnesses, including atypical psychosis, schizoaffective disorder, delusional disorder or persistent persecutory state (source: Psychology Central). I am sure when you search under this term you will end up with substantial amounts of resources, including for example the DSM-V manual, where it is included, albeit quite vaguely defined according to Sachdev et al. (2015).

Manuals that address it in diagnosis or didactically?

Under the more popular name late-onset psychosis, you can find its diagnostic characteristics in the DSM-V manual as stated above, in The Psychosis Manual from Smith et al., in this Master's thesis, among hosts of other sources.

<sub>References
- Howard et al., Am J Psychiatry (2000); 157(2): 172-8
- Lubman & Castle, Current Psychiatry (2002); 1(12): 35-44
- MacDougall, Master's thesis (2011), McMaster University
- Ravindran et al., Can J Psychiatry (1999); 44(2):133-7
- Sachdev et al., Harv Rev Psychiatry (2015); 23(5): 320–8
- Sato & Idha, Psychogeriatrics (2002); 2(1): 20–5</sub>