Dr. Ballas Answers: Late-Onset Schizophrenia

For the my husband behaves strangely only with me and to a lesser extent with those who happen to contradict him.  this is not schizophrenia since he is perfectly normal outside the house when he does not see me. With me he is suspicious, very abusive both physical and mental and continues to talk without any reason.  I am blamed for everything that happens.  please help me- at least I want to know if this is a mental disorder and if so what is it.  For me life is a real hell.  

Hi:

My dad had a severe case of viral encephalitis this summer (tests as to which kind were inconclusive). He made a remarkable recovery but this month has started acting manic, and this week has entered some sort of psychosis. He keeps getting undressed, telling us random stories where he switches subjects too often to follow, and laughs hysterically and then cries. It is strange that this is happening now. I wonder if it is possible that he could have developed some sort of schizophrenia as the result of encephalitis? Also, I would apprecitate suggestions for my mom who doesn't know how to care for him when he is in this state. He's a happy, positive psychotic, but who knows if he'll stay that way. He's currently in the hospital for observation, but no one seems to really give us answers. 

I would put forth the contention that "late onset schizophrenia," is something else altogether moving through a pathway common to schizophrenia but different in etiology, nevertheless. Olfactory hallucinations are more often seen in people who have some neurological problem. Depression with psychotic features is not unusual (as are paranoid features) in the aging population. I am as skeptical of late onset schizophrenia as I am of childhood schizophrenia. Although I am open to reading more literature on the subject.

docsamwise

Your blog was very interesting.  I have an ex-friend that has recently stormed back into my life (not my choice). She is paranoid, gradiose and delusional, yet believable at times! I noticed bizarre behavior 9 years ago when she was 40.  Our friendship ended and now she is 49 and is acting crazy.  She describes detailed conspiracy theories against her, phone tapping, spying, etc. She even said she was arrested and held in a detention center for 3 weeks. She had bee thrown out of her apartment and is asking for money. Her family says she is harassing many family members and friends. She also refuses help. I do not know what went on during the 9 years that I did not have contact with her.  Could this be late onset schizophrenia? She did have an aunt who had these symptoms later in life (>60 yrs, I think).   

Thank you for your explanation.  It has been difficult to find good information and your comments were really helpful.

Hi, 

My father passed away last year from a massive heart attack.  My sister noticed a few years earlier that he was exhibiting signs of paranoid schizophrenia.  Some of which were confirmed in random entries in note books that he kept up until he died.  He thought people were always following him, that people he came in contact with were trying to "get him" and he heard voices.  What I can tell you for sure is that my father was a very smart, self educated man.  He had a very long successful career in the military.  Married and divorced twice.  Was a very handsoff type father.  He exhibited a loaner type personality through out his life and moved every two years to various cities and towns.  He was quick to terminate relationships whether family or friends.  He refused most of his adult life to go to a doctor for anything at all.  (not the way his parents brought him up.)  I was sad to learn that he had lead such an isolated life towards the end.  He did struggle with alcohol abuse on and off in his adult years but that didn't appear to be the case when he passed away.  He is the youngest of 4 kids, the only boy.  There is a 21 year gap between him and his two oldest sisters.  I believe my grandfather was in his early 50's when my father was conceived.  My father was born in Eastonia, a Northern European country. A few years before he died he rode his bicycle from Calgary, Alberta to Wawa, Ontario 2500 km.  This does and does not sound like your typical schizophrenic.  I guess what I want to know is did he KNOW he had this disease??  Do these folks know they have it?  What is it like for them?  Could they tell the difference between the disease and reality? 

Thank you so much for this blog. The info was very helpful.

My co-worker at age 53 is showing symptoms of LOS. She thinks people are talking about her, following her into stores, that the police are after her and so on. She has always seemed paranoid but never this delusional; it just started this year. She is educated and a university instructor. She will go on leave but I wonder if she will be able to return if she takes the proper medication.

This is fascinating...there seems to be so few resources out there on late onset schizophrenia.  A lot of what you said describes my mom...she didn't have full-on periods of psychosis (that we were aware of) until I left for college. I was questioning whether it was truly schizophrenia at first because she didn't display any of the negative symptoms found in the DSM-IV.  But she's got everything else...sight & smell hallucinations, debilitating persecutory delusions, and near-constant auditory hallucinations.  Except she likes her voices...they seem to be warning her of all the bad stuff going down around her.

It has now come to light that her father was displaying increasingly troubling symptoms of extreme paranoia before he died in his late sixties.  (My grandmother had hid it at the time because she was embarrassed.)  It was nice to hear that there's less chance of inheritance in these situations but it seems like my family might be an exception :(  Oh, and I just found out that two distant cousins, relatives of my maternal grandfather, also have the disease.  But it developed in the early 20's for them.

If you know of where I can read more about this, or if any advances have been made in the genetic testing department, please let me know.  My mom refuses all medications--she is quite paranoid and has no idea she's ill.  Two attempts at hospitalization haven't been successful.  She threatens to sue and usually gets released within a week.  I really don't want to end up down the same road in another 15-20 years...