Aust Fam Physician
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Psychotic symptoms in the elderly arise in mood disorders, schizophrenia, dementia, and delirium. ⋯ Management follows logically from a thorough mental state examination, medical work up and accurate diagnosis. Depression and mania with psychotic symptoms respond best to an antidepressant and mood stabiliser respectively, usually in combination with antipsychotic medication. Severe cases require electroconvulsive therapy. Atypical antipsychotics are now the treatment of choice in late life schizophrenia. Psychotic symptoms are common in dementia but usually fade within 6-12 months. Doses of psychiatric medications should therefore be lowered every 3 months to check that continued treatment is necessary. Most cases of delirium do not require psychiatric medication.
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A recent New South Wales Supreme Court case explored some interesting and novel concepts with respect to the law and mental illness. This article outlines the case and summarises the legislation in each Australian state and territory which regulates the care and treatment of patients who have a mental illness.