Hypochondriasis and paranoia: similar delusional systems in an institutionalized geriatric population.

Hypochondriasis and paranoia are common psychopathologies of aging. The former may be secondary to depression or organic brain syndrome, whereas the latter may be secondary to sensory impairment or organic brain syndrome. Paranoid schizophrenia, with delusions of grandeur, is rare in later life. The authors classified 273 institutionalized geriatric patients by means of staff ratings into categories such as lucid and alert, confused, hypochondriacal, paranoid, etc. Among confused patients there was a correlation of .45 (p less than .001) between hypochondriasis and paranoia. Even among nonconfused patients, there was a slight positive correlation. The authors concluded that geriatric paranoia and hypochrondriasis have similar structure (delusion) and functions (safeguarding self-esteem and manipulating others). An interpersonal perspective can also provide guidelines for when to treat these conditions.