Initially, patients usually have insight so that the hallucinations are benign in terms of their immediate impact, but have poor prognostic implications, with increased risk of dementia, worsened psychotic symptoms, and mortality. Delusions occur in about 5-10% of treated patients, and are considerably more disruptive, being paranoid in nature, of spousal infidelity or family abandonment. Psychosis is an independent risk factor for nursing-home placement.[23]