About Paraphrenia


Paraphrenia is a mental disorder characterized by an organized system of delusions, there may be hallucinations, but not emotional flattening, that is, without the deterioration of the personality or disorders of the course of thought, that is, negative symptoms.


Differences between paraphrenia and schizophrenia

Paraphrenia is different from schizophrenia because, although both disorders produce delusions and hallucinations, people with schizophrenia exhibit personality changes and deterioration, while individuals with paraphrenia maintain a well-preserved personality and affective response.

The onset of symptoms generally occurs later in life, around the age of 50, the prevalence of the disease among the elderly is between 2-4%.

Paraphrenia is not included in DSM-IV. Psychotherapists often diagnose patients with paraphrenia as atypical psychosis.

In France, the name Chronic Delusional Psychosis is used to regroup a set of mental disorders similar to schizophrenic syndromes, but which are distinguished by the lack of deep dislocation at the personality level.

This group of psychoses are characterized by a structural alteration of the personality that allows the installation, development and spread of permanent delusions.

Intuitions, interpretations, illusions and hallucinations radically disturb the system of ideas, judgments and beliefs, and permeate the affective and relational life causing a constant refraction of the subject towards the outside world through a delusional prism.

From an evolutionary point of view, chronic delusions do not evolve towards a dissociation of the different sectors of the personality or towards organic dementia.

Likewise, some of them may remain for a long time compatible with a good adaptation relative to external contingencies.

Among the chronic delusions without dissociative evolution (not schizophrenic), or deficit, we find the following pictures:

Paranoid systematized delusions, which include both passionate delusions, sensitive relational delusions and systematized interpretive delusions, chronic hallucinatory psychosis, and paraphrenias.

For Henri Ey: it is a huge delusional production with a multiplicity of themes, mainly megalomaniacs and cosmic, an archaic, magical or paralogical thought, indifferent to the development of the logical conceptions of an intact intelligence.

The preservation of a good relationship with the real world despite the absurdity of the fiction that is superimposed on it and the absence of significant mental deterioration.

Paraphrenic delusions are not lived, thought, meditated or dreamed delusions, but rather, spoken delusions that cannot be silenced.

Paralogical thinking is magical thinking, where fantasy unleashes a delusional fable that transcends all categories of understanding.

Symptoms of paraphrenia

Patients also have a lack of symptoms commonly found in other paraphrenia-like mental disorders.

There is no significant deterioration of intelligence and personality. Patients are also well oriented in time and space.

Possible causes


Paraphrenia, in some cases, is associated with a physical change in the brain, such as brain lesions that lead to subcortical dysfunction that could lead to delusions.

Predisposing factors

Many of the patients who present with paraphrenia tend to have significant hearing impairment or vision loss, are socially isolated with a lack of social contact, do not have a permanent home, are single and childless, and have maladaptive personality traits.

While these factors do not cause paraphrenia, they make individuals more likely to develop the disease later in life.


Although the diagnosis of paraphrenia is not currently included in the DSM-IV or ICD-10, many studies have recognized the condition as a viable diagnostic entity that is different from schizophrenia with organic factors playing an important role in a good part. of the sick.

The differences between the sexes

While paraphrenia can occur in both men and women, it is more common in women.


It is seen mainly in patients older than 60 years, but the origin has been known to occur in patients between 40 and 50 years.

Personality type and life situation

It is suggested that people who develop paraphrenia late in life have a premorbid personality. Many patients were also described as lonely, eccentric, and with personality disorders.


The development of paranoia and hallucinations in old age has been related both auditory and byvisual impairment. People with paraphrenia often present with one or both of these deficiencies.

In recent medicine, the term paraphrenia has been replaced by that of, very late-onset, schizophrenia-like psychosis, and has also been called atypical psychosis, or delusional disorder.

Current studies, however, recognize the condition as a viable diagnostic entity that is different from schizophrenia, with organic factors playing a role in a significant portion of patients.

The line between lies and sickness

Paraphrenic syndrome can be confused with the interest to fantasize. For example, for the schizoid type simply characteristic care is his inner world and his fantasies.

The invention of a world, the patient for his part, begins to believe that everything is true, what he himself invented.

Symptoms taken from other disorders

In addition to its symptoms, paraphrenic syndrome can have the same symptoms as other syndromes, such as:


-Capgras syndrome or socias, There is an unknown substitution for familiar people and vice versa. True friends, loved ones, and even family members are perceived as strangers and hitherto unknown.

-Fregoli syndrome. One and the same person in the eyes of the patient begins to take the form of different people. For example, seeing a friend, a patient may first recognize him and at the next meeting find that he is someone famous.

First, the patient is prescribed antipsychotics, which help stabilize the general condition of the patient and also reduce delirium.


– Ey H. Position actuelle des problèmes de la démence precoce et des états schizophréniques. In: Schizophrénie. Études cliniques et Psychopathologiques, Les empêcheurs de penser en rond. Le Plessis-Robinson: Synthélabo; 1996. p. 61-79.

-Rev. Asoc. Esp. Neuropsiq. vol.34 no.124 Madrid 2014Paraphrenias: nosography and clinical presentation.Paraphrenia: nosography and clinical presentation. Christian widakowich


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