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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO311

Late-onset fraud-themed delusions: a case associated with dementia

LATE-ONSET DELUSIONS WİTH FRAUD THEME: A CASE ASSOCİATED WİTH DEMENTIA

Fraud-themed delusions that emerge in later life and fail to respond to antipsychotic treatment may indicate an underlying neurocognitive disorder and may benefit from cholinesterase inhibitor treatment.

The aim is to present a case initially considered to be primary psychosis but subsequently associated with dementia. A 72-year-old woman with no psychiatric history presented with a two-year history of fraud-themed delusions; she believed that people she communicated with online would send her a large inheritance and repeatedly sent them money, incurring financial losses early in the course of the illness. Assessment included a mental status examination, the Mini-Mental State Examination (MMSE), brain magnetic resonance imaging (MRI), and electroencephalography (EEG). Examination revealed restricted affect, impaired judgment, and impoverished thought content, with no perceptual disturbances; her MMSE score was 21/30, MRI showed age-appropriate cortical changes, EEG demonstrated diffuse slowing, and laboratory findings were within normal limits. Paliperidone at doses of up to 6 mg/day produced no significant clinical response; following a neurology consultation, dementia was suspected and donepezil 10 mg/day was initiated. After one month, partial improvement in insight, reduced conviction in delusional beliefs, and improved family functioning were observed; no new financial losses were reported in the preceding six months. The authors conclude that late-onset delusions accompanied by cognitive impairment warrant evaluation for dementia, that cholinesterase inhibitors may be beneficial in cases resistant to antipsychotic treatment, and that these patients are vulnerable to financial exploitation.

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