First-episode psychosis in a 101-year-old male

Abstract

An elderly gentleman, age 101 years, was brought in with first episode of onset of psychotic features, diagnosed with paranoid schizophrenia [ICD F20.0] as well as VLOSLP (Very Late Onset Schizophrenia Like Psychosis). He responded well to treatment and achieved complete remission. Remarkable in his case was his advanced age coupled with the lack of any the usual cognitive detriment prevalent in geriatric population. Notably, he had mildly elevated CRP (C- Reactive Protein) levels, which could both lend validity to neurodegenarative theory of schizophrenia and possibly indicate imminent onset of cognitive decline, but more longitudinal data is needed to be conclusive. Furthermore, despite satisfying the primary criterion of VLOSLP i.e. age of onset, his presentation and recovery does not fit its typical narrative, perhaps calling for more diversification in characterization of old age psychosis.

Keywords

• Elder psychosis
• first-episode
• geriatric psychosis
• schizophrenia
• very late-onset schizophrenia-like psychosis