Psychosocial correlates of late-onset psychosis: life experiences, cognitive schemas, and attitudes to ageing.

BACKGROUND

Psychosis with first onset after the age of 60, and arising in the absence of dementia or primary affective disorder, is thought to affect 2-4% of older people, and as many as half will not respond fully to medication.

AIMS

This study represents a preliminary attempt to explore a number of possible psychosocial correlates of late-onset psychosis with potential relevance for a cognitive-behavioural formulation and for the development of psychosocial interventions for this group.

METHODS

The nature and extent of adverse early life experiences, presence of maladaptive cognitive schemas, and morale in relation to ageing were compared for older people with a diagnosis of late-onset psychosis (LOP; n = 14) or late-onset depression (DEP; n = 13) and healthy older volunteers (HEV; n = 18) in a cross-sectional design.

RESULTS

Both LOP and DEP groups reported significantly higher levels of adverse life experiences than the HEV group, with between-group differences in the types of experiences described. The LOP group scored significantly higher than the HEV group on four out of five schema domains, and significantly higher than the DEP group on two domains, other-directedness and over-vigilance/inhibition. The LOP group had significantly lower overall morale in relation to ageing than the HEV group, reflecting significantly higher levels of lonely-dissatisfaction.

CONCLUSIONS

Life experiences, cognitive schemas and attitudes to ageing are important psychosocial correlates of LOP. These findings contribute to an understanding of the emotional world of individuals who develop psychosis in later life and may have implications for developing more effective intervention approaches.