So far in Vietnam does not have a systematic study of paranoid symptoms in depressive disorders in the elderly. Objective: Describe the characteristics of paranoia in depressive disorders in the elderly. Preliminary remarks treatment of psychotic depression in the elderly. Methods: Description, research that uses advanced psychological testing support. Results: In 45 patients with depression in the elderly aged 60 years or older. The expression of psychosis: 60 percent of patients with pure paranoia, 33.3 percent of patients had paranoid delusions combined , some patients have hallucinations only a small proportion (6.7 percent). The paranoid mood suitable to meet higher rate: Paranoid hypochondriac (75.6 percent), paranoid self-incriminating (68.9 percent). The new antidepressant widely used in the treatment, accounting for 91.1 percent. Good results can only be in 51.1 percent of patients. Conclusion: Paranoid symptoms are common in depressive disorders in the elderly. The symptoms are varied so the diagnosis easy to miss or mistake. It should be recognized for the diagnosis and appropriate treatment.