To the Editor: At the risk of being isolationist, I want to take issue with the international consensus on late- and very-late-onset "schizophrenia-like psychosis" (1). I see no heuristic advantage and potentially great therapeutic harm in labeling patients with such illnesses schizophrenic, no matter the prefix or suffix. Conceptually, I thought the international consensus was that schizophrenia is likely a developmental disorder resulting from an interaction between a genetic predisposition and adverse gestational, labor and delivery, or perhaps neonatal effects on the developing nervous system. Furthermore, this initial lesion expresses itself in childhood with neuromotor, cognitive, and emotional deficits and in late adolescence and young adulthood as a nonaffective psychosis, most likely with negative symptoms and a variable but generally poor long-term course (2). How are we to reconcile this concept with the schizophrenia that develops after 40 or 60 years of age? If we cannot, why call the late-onset psychosis "schizophrenia"? What is wrong with Kraepelin’s term "paraphrenia"?