Sunday, January 15, 2006

paranoia

Paranoia is a psychotic reaction that frequently involves delusions. In the older person, paranoid reactions may result from social isolation or from reduced sensory capabilities. For example, the person with a hearing impairment may not be able to determine what is actually being said and will impart hostile motivations to those who are present. This type of paranoid behavior is fairly common among older people. Some people will have mild symptoms consisting of, for example, suspecting thievery while searching for articles that have been misplaced or lost. Such thoughts often respond to explanations and reassurance. Other people are highly delusional and may have visual or auditory hallucinations, hearing or seeing things that do not exist. They frequently think people are playing tricks on them or conspiring against them. In each case, treatment of the paranoia requires dealing with the underlying cause. This involves correcting visual or hearing defects and use of psychotherapy, tranquilizing drugs, and occasionally, in severe cases, shock therapy.
Elderly paranoid people are rarely dangerous but are often frightened and anxious. A devoted family who encourages the person to pursue treatment can be of invaluable assistance in the management of such cases.
See also ANXlETY.
Steinberg, F. U. Care of the Geriatric Patient. 6th ed. St. Louis: C. V. Mosby Co., 1983.

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