Katakami Shigeki, Satake Yuto, Suehiro Takashi, Ishimaru Daiki, Nakanishi Erina, Kanemoto Hideki, Yoshiyama Kenji, Ikeda Manabu
Department of Psychiatry Osaka University Graduate School of Medicine Suita Osaka Japan.
Present address: Division of Psychiatry University College London London UK.
PCN Rep. 2024 Dec 10;3(4):e70040. doi: 10.1002/pcn5.70040. eCollection 2024 Dec.
Very late-onset schizophrenia-like psychosis (VLOSLP) is a psychotic disorder with an age of onset ≥60 years, and social isolation is a risk factor. Reports on the impact of interventions for isolation and loneliness on psychiatric symptoms in VLOSLP are limited.
An 87-year-old woman, widowed and living alone, developed psychosis, including paranoia, erotomania, and visual hallucinations, at 84 years old during a period when her interactions with others were limited by the COVID-19 pandemic and osteoarthritis. She was eventually brought to our hospital with a local dementia outreach team. She was admitted and diagnosed with VLOSLP with mild cognitive decline through imaging and neuropsychological tests confirming the absence of dementia. Immediately after admission, her psychotic symptoms became inactive. She was transferred to another psychiatric hospital to prepare for her move to a long-term care facility because her psychosis was alleviated. During admission, she enjoyed the company of others and occupational therapy, and her score on the UCLA Loneliness Scale Version 3 improved from 44 at admission to 35 at discharge.
The admission itself improved the patient's psychosis, which seemed to be related to the alleviation of isolation and loneliness.
迟发性精神分裂症样精神病（VLOSLP）是一种起病年龄≥60岁的精神障碍，社会隔离是一个危险因素。关于针对隔离和孤独的干预措施对VLOSLP患者精神症状影响的报道有限。
一名87岁的寡妇独居，在84岁时出现精神病症状，包括妄想、色情狂和幻视，当时她与他人交流因新冠疫情和骨关节炎而受限。她最终由当地痴呆症外展团队送至我院。经影像学和神经心理学检查确诊无痴呆后，她入院并被诊断为伴有轻度认知衰退的VLOSLP。入院后，她的精神病症状立即得到缓解。由于她的精神病症状已缓解，她被转至另一家精神病医院，为入住长期护理机构做准备。住院期间，她喜欢他人陪伴和接受职业治疗，她在加州大学洛杉矶分校孤独量表第三版上的得分从入院时的44分降至出院时的35分。
入院本身改善了患者的精神病症状，这似乎与隔离和孤独感的减轻有关。
