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Quantitative Magnetic Resonance Imaging Volumetry Distinguishes Delusional Disorder from Late-Onset Schizophrenia

Published online by Cambridge University Press:  02 January 2018

Robert J. Howard ,
Osvaldo Almeida ,
Raymond Levy ,
Phillipa Graves  and
Martin Graves
Robert J. Howard*
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London
Osvaldo Almeida
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London
Raymond Levy
Affiliation:
Section of Old Age Psychiatry, Institute of Psychiatry, London
Phillipa Graves
Affiliation:
Phillip Harris Magnetic Resonance Centre, Department of Radiological Sciences, Guy's Hospital, London Bridge, London SE3 9RT
Martin Graves
Affiliation:
Phillip Harris Magnetic Resonance Centre, Department of Radiological Sciences, Guy's Hospital, London Bridge, London SE3 9RT
*
Dr R. J. Howard, Institute of Psychiatry, De Crespigny Park, Camberwell, London SE5 8AF
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Abstract

Background

Late paraphrenia is recognised as a heterogeneous disorder. This is reflected by the division of such patients into schizophrenia and delusional disorder in ICD-10. Earlier imaging studies have suggested that major structural abnormalities may be associated with the onset of psychosis in later life.

Method

Fifty late paraphrenics and 35 age-matched healthy controls underwent structural magnetic resonance imaging of the whole brain in the coronal plane. Measurements were made of intracranial and brain volumes and the volumes of the intracerebral and extracerebral cerebrospinal fluid spaces.

Results

No differences in intracranial, brain or extracerebral cerebrospinal fluid volumes between patients and controls were found. Late paraphrenic patients had greater lateral and third ventricle volumes than controls and the left lateral ventricle was larger than the right. When the patients were divided into appropriate ICD-10 diagnoses: paranoid schizophrenia (n = 31) and delusional disorder (n = 16), lateral ventricle volumes in the delusional disorder patients were much greater than those of the schizophrenics and almost twice those of controls.

Conclusions

Structural brain differences underly diagnostic heterogeneity within late paraphrenia. The brains of late onset schizophrenics are only subtly different from those of healthy elderly individuals.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 4 , October 1994 , pp. 474 - 480
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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