Department of Psychiatry, University of Toronto, #605 260 Heath St. West, Toronto, ON, M5P 3L6, Canada.
Psychiatr Q. 2018 Dec;89(4):881-889. doi: 10.1007/s11126-018-9588-1.
The elderly with dementing illness often present with psychotic symptoms such as delusions, but the thematic content of delusions in the elderly differs from that of delusions expressed by younger individuals, and can be pathognomonic of early dementia. The aim of this paper is to review the recent literature on the delusion of theft, the most prevalent delusion in the elderly, in order to arrive at a deeper understanding of its sources and to identify successful therapeutic approaches. The literature from 2000 to the present was searched on the Google Scholar database using relevant search terms. Several older classical papers were also referenced. Understanding the origins of the delusion of theft - multiple losses, attempts at attributing such losses to an outside source, attempts at reliving a happier past - helps in devising responses that are comforting to the patient. The distress that often accompanies the delusion of having been robbed can be decreased by nursing home improvements in the handling of personal possessions, by the correction of sensory deficits, and by the provision of activities that distract from loneliness. Attention to stimuli that trigger the delusion helps to limit its occurrence. Medications may help, but can sometimes make matters worse. Understanding that delusional thinking can arise from sensory and cognitive deficits is critical to empathic caregiving and also to the lessening of caregiver burden.
患有痴呆症的老年人常出现精神病症状，如妄想，但老年人的妄想主题内容与年轻个体表达的妄想不同，且可能是早期痴呆的特征性表现。本文旨在回顾关于盗窃妄想的最新文献，盗窃妄想是老年人最常见的妄想，以便更深入地了解其来源，并确定成功的治疗方法。使用相关搜索词在 Google Scholar 数据库中搜索了 2000 年至今的文献，还参考了一些较旧的经典论文。理解盗窃妄想的起源——多次损失、试图将这些损失归因于外部来源、试图重温更快乐的过去——有助于设计出让患者感到安慰的应对方法。通过改善养老院对个人财物的处理方式、纠正感觉缺陷以及提供分散孤独感的活动，可以减轻盗窃妄想带来的痛苦。注意引发妄想的刺激因素有助于限制其发生。药物可能会有帮助，但有时也会使情况变得更糟。了解到妄想思维可能源于感觉和认知缺陷，对于富有同情心的护理以及减轻护理人员负担至关重要。
