‘Not of this world’: The subjective experience of late-onset psychosis

Abstract

Objectives: Psychosis with first onset after the age of 60 arising in the absence of dementia or primary affective disorder is thought to affect 2–4% of older people. Up to half will not respond fully to medication.The subjective experience of living with late-onset psychosis (LOP) has not yet been considered and this study represents a preliminary attempt to explore the subjective experience and psychological features of older people living with LOP.

Method: The study was conducted in Ireland. Seven participants between the ages of 67 and 87 years who met diagnostic criteria for very late-onset schizophrenia-like psychosis were interviewed using a semi-structured interview schedule. Participants spoke about previous life experiences as well as the experience of developing and living with LOP. Interpretative phenomenological analysis was used to identify common themes within their accounts.

Results: Four themes emerged which reflected participants’ subjective experiences of earlier life stages as well as their current experiences of LOP. Three interrelated themes described participants’ experiences of social isolation, a solitary coping style and the experience of the self as ‘different’. A final theme reflected participants’ attempts to explain and find meaning in their psychotic experiences.

Conclusions: Results support the view that the experience of LOP emerges in the context of psychosocial vulnerabilities combined with adversities associated with the experience of ageing.

Keywords:

• older adults
• ageing
• very late-onset schizophrenia-like psychosis
• late paraphrenia
• interpretative phenomenological analysis

Acknowledgements

We would like to thank the seven participants in this study who agreed to share their experiences with us. Thanks also to Margo Wrigley, Simon Wale and all clinicians whose dedicated efforts assisted in identifying participants for the study. Thanks are also due to Louise Kinsella who kindly assisted with the cross-validation of transcript content and the final thematic account.