Psychosis in older people receives perplexingly little attention compared with dementia and depression. I have never understood why this should be so, as these patients constitute some of the most memorable that old age psychiatrists encounter and often show remarkable responses to antipsychotic treatment. Opaque and unhelpful terminology, combined with uncertainty about how such patients should be viewed in relation to schizophrenia in young people and psychoses that arise secondary to organic brain conditions, have played important parts in reducing interest. Psychosis in the Elderly is a welcome and accessible multi-author book and an important step in the right direction towards rehabilitation of this area. The title reflects the broadness of scope of the Melbourne-based editors' project, which is really a series of excellent mini-reviews on psychosis in association with a wide range of neuropsychiatric disorders as well as schizophrenia in older people. In recent years, some of us have advocated conceptualisation of ‘late-onset schizophrenia’ as a term to describe cases of schizophrenia with onset delayed beyond the age of 40 and ‘very late-onset schizophrenia-like psychosis’ for those cases with onset after 60 which seem to have a different set of risk factors and clinical features. Chapter contributors expand on this distinction and update the reader on recent research findings on aetiology, pathophysiology and treatment response. But the most novel aspect of the book is the final section which extends into the territory of psychoses associated with delirium, dementia, affective disorders, stress and alcohol and substance misuse in older people. I would like to see this book sell well and am confident that it will gain deserved recognition as required reading for old age psychiatrists in training.
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