Care for Social Isolation and Loneliness in a Case With Late-Onset Delusional Disorder
Open accessAbstract
Late-onset psychosis refers to the development of psychotic symptoms after the age of 40 and can encompass various conditions like schizophrenia, mood disorders with psychotic features, and delusional disorder. Non-pharmacological interventions are critically important in older adults with psychosis, especially considering the lack of evidence for the efficacy of antipsychotics and the high risk of side effects. Social isolation is recognized as one of the risks of late-onset psychosis, and interventions to eliminate this risk are becoming increasingly important in Japan, where social isolation among older people is widespread as society ages. We present a case of late-onset delusional disorder in which multidimensional interventions for social isolation and loneliness, which have significant impacts on symptoms, were effective in achieving persistent remission. The case involved a woman in her mid-70s who began to complain of paranoia that taking a painkiller recommended by her husband caused persistent pain. Her husband's hospitalization and the deterioration of her relationship with her children resulted in her becoming socially isolated, which intensified her delusions and led to aggressive behavior and depression. Although antipsychotic medications had a limited effect, remission was achieved through supportive psychotherapy, cognitive therapy, family education, participation in group occupational therapy, and the introduction of daycare services, which were implemented to reduce loneliness and social isolation. Specifically, supportive psychotherapy and family education for her loneliness, awareness of another possible cause of pain that she developed through Socratic questioning, and environmental adjustments played important roles in preparing her to accept cognitive therapy, achieve delusional remission, and maintain her state of remission, respectively. The interventions implemented in this case provide insights for addressing social isolation and loneliness in late-onset psychosis.
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When consciousness attributions to chatbots express non-bizarre delusions, the related interferences with users' well-being may be short-lived or not yet disrupt most areas of their life functioning.
“when consciousness attributions to chatbots express non-bizarre delusions, the related interferences with users' well-being may be short-lived or not yet disrupt most areas of their life functioning (e.g., in otherwise healthy individuals under prolonged loneliness, trauma; Kanemoto & Kawasaki, 2024).”
From Are Attributions of Consciousness to AI Chatbots Epistemically Innocent? (2026) · cites this paper as Kanemoto & Kawasaki, 2024
The Discussion (page unavailable) says people with late-onset psychosis can maintain their ability to live despite strong delusions, and describes loneliness as a factor in this case. But this patient’s delusions persisted for more than six months; the paper does not address chatbot consciousness attributions, trauma, or short-lived effects on well-being. (LLM, conf=0.85)
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Cited by
Sorted by citations
Are Attributions of Consciousness to AI Chatbots Epistemically Innocent?
Peters, U. (2026) · Minds and Machines · doi:10.1007/s11023-026-09795-8
- Authors
- Kanemoto, H., & Kawasaki, T.
- Affiliations
- Medical Corporation River Mizuma hospital (JP)
- Corresponding author
- Kanemoto, Hideki
- ORCID
- Kanemoto, Hideki
- Venue
- Cureus
- Published
- 2024-03-22
- Volume
- 16
- Issue
- 3
- Pages
- e56697-e56697
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC11032510
- OpenAlex
- W4393072515
- Cited by
- 3
- References
- 0
- Citations by year
- 2024: 3
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- diamond
- dx.doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Eisai
- Otsuka Pharmaceutical
- Japan Society for the Promotion of Science (21K15730, T21K157300)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- late-onset psychosis, social isolation, loneliness, older adults, supportive therapy, cognitive therapy, family education, group occupational therapy, daycare services, Socratic questioning, paranoia, non-pharmacological treatment
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