Late-onset psychoses are a heterogeneous group of disorders whose nosology has been controversial throughout history. Several methodological limitations have made difficult the comparison among studies and, as a consequence, the research interest has been little, leading to the absence of late-onset schizophrenia and paraphrenia in current official classifications.

To highlight the specific symptoms of late-onset schizophrenia as well as its differences with other psychoses though the study of a case report.

A 70-year-old woman developed psychotic symptoms during the last seven years, consisting of auditory and olfactory hallucinations, telepathic phenomena and injury delusions, erotomania and thought control, with a high level of systematization and fantasy. She was admitted in an inpatient unit. She was treated with risperidone and the psychotic symptoms got better. At the time of hospital discharge, hallucinations and delusional thoughts had disappeared and no behavioral or emotional disorder was observed. Some weeks later, risperidone had to be substituted by paliperidone due to side effects, such as tremor, sialorrhea and parkinsonism.

Late-onset schizophrenic psychosis is not as exceptional as it has been traditionally considered. One of the main problems is that current classifications do not include specific diagnostic categories for cases of late or very-late-onset psychoses. It would be necessary that future ICD-11 and DSM-V classifications will include different-age criteria when diagnosing mental disorders.