KEY woms-Late paraphrenia, review. Roth and Morrissey (1952) adopted the term 'late paraphrenia' to describe 'a specific group of elderly patients with a well organised system of paranoid delusions and hallucinations, existing in the setting of a well preserved personality and affective response'. The concept of late paraphrenia was further developed by Kay and Roth (1961) as 'a suitable descriptive term, without prejudice as to aetiology, for all cases with paranoid symptomcomplex in which signs of organic dementia or sustained confusion were absent, and in which the condition was judged from the content of the delusional and hallucinatory symptoms not to be due to primary affective disorder'. The onset of the symptoms was usually over the age of 60.
The diagnosis of late paraphrenia came rapidly into use in Great Britain and in other European countries. Nevertheless, its concept was not unequivocally accepted. Fish (1 960) suggested that late paraphrenia comprised a heterogeneous group of non-organic paranoid states, an idea later supported by Holden's (1987) catamnestic study. Others (Grahame, 1984;Harris and Jeste, 1988) claimed that late paraphrenia was nothing but schizophrenia with a late onset. The uncertainty about the concept of late paraphrenia was not the only point of dispute; the use of the term 'paraphrenia' itself was often criticized.
Kraepelin (1 9 19) suggested the term 'paraphrenias' to describe a group of individuals who shared some of the features of schizophrenia, but whose affect, will and personality were largely preserved. Prominent paranoid delusions were considered the basic psychopathological disturbance in these patients. He (Kraepelin, 1919) conceded that the initial diagnosis of paraphrenia could not be sustained in some of his patients, which provoked uncertainty about its validity. Mayer