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Ekbom’s syndrome (delusional infestation) and body dysmorphic disorder
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
More recently, Freudenmann and Lepping (2009) have argued for a further change in nomenclature to “delusional infestation”:The name “delusion of parasitosis” was introduced in 1946 … and it became the most common name in the literature. An alternative was “delusional parasitosis.” However, in recent years, patients have reported the presence of specific parasites less commonly, and the name thus has the disadvantage of covering only one sort of pathogens. We therefore recommend the use of the broader term “delusional infestation” in the future. This name highlights the core psychopathological feature (a thought disorder) and covers all kinds of (even “newly emerging”) imaginary pathogens by referring to the delusional theme “infestation” and not to a single species.
Management of skin disease
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
This is a rare psychosis in which the individual believes that his or her skin is infested with insects or worms. Often, sufferers will bring to the doctor rolled up horn or other skin debris and point proudly to the ‘infesting insect’. They may point to blemishes on the skin as evidence of their problem. These patients’ beliefs are quite unshakeable, and beyond psychiatrists’ help. Antipsychotic drugs may be helpful for patients with delusional parasitosis.
A systematic review of antipsychotic agents for primary delusional infestation
Published in Journal of Dermatological Treatment, 2022
Meghan L. McPhie, Mark G. Kirchhof
Delusional infestation (DI), also referred to as delusional parasitosis, is a rare delusional disorder of somatic type characterized by the fixed, false belief that one is infested with parasites, insects, worms, mites, bacteria, fungus, or other living organisms, despite the lack of objective medical evidence that such infestation exists (1). Individuals with DI often report cutaneous symptoms, such as itching, crawling, biting, stinging, and pins and needles sensations which they attribute to the presence of small pathogens (2). There are two widely recognized variants of DI. Primary DI is a psychiatric disorder in which the only presenting symptom is the delusion of parasitic infection. On the other hand, secondary DI occurs when the symptom of another psychiatric condition, medical illness, or substance use causes the delusion (2). Although DI is considered a psychiatric condition, individuals often consult dermatologists due to their somatic concept of the illness and skin findings (3).
Historical and clinical considerations on Ekbom’s syndrome
Published in International Review of Psychiatry, 2020
Laura Orsolini, Alessia Gentilotti, Matteo Giordani, Umberto Volpe
Primary delusional parasitosis/infestation is often managed with antipsychotic treatment, whereas secondary delusional parasitosis is managed by addressing the underlying cause. However, antipsychotics may also be prescribed symptomatically also for managing delusional infestation secondary to medical disorders (Campbell et al., 2019; Moriarty et al., 2019). As first-line treatment agent, pimozide (1–10 mg daily) was advised (Driscoll et al., 1993; Koo & Lee, 2001; Lepping et al., 2007), even though it has been gradually replaced by newer second-generation antipsychotics, due to its extrapyramidal and cardiotoxic side effects (Cubała et al., 2011; França et al., 2018; Lee, 2008; Wong & Bewley, 2011). A systematic review investigating the effectiveness of first- and second-generation antipsychotics for treating primary ES, did not report any clinically relevant difference in terms of effectiveness, even though the authors pointed out that evidence was weak as it was derived only from case reports and case series (Lepping et al., 2007).
‘Come share my world’ of ‘madness’: a systematic review of clinical, diagnostic and therapeutic aspects of folie à deux
Published in International Review of Psychiatry, 2020
Giulia Menculini, Pierfrancesco Maria Balducci, Patrizia Moretti, Alfonso Tortorella
Schizophrenia of various subtypes was the most represented psychiatric diagnosis among primary subjects (Gralnick, 1942; Kashiwase & Kato, 1997; Kraya & Patrick, 1997; Nielssen et al., 2013; Shimizu et al., 2006; Silveira & Seeman, 1995; Vigo et al., 2019), followed by paranoid reaction (Gralnick, 1942; Kashiwase & Kato, 1997), delusional disorders (Shimizu et al., 2006; Silveira & Seeman, 1995) which appeared to be prevalent in one study (Arnone et al., 2006) and mood disorders, both unipolar and bipolar (Arnone et al., 2006; Gralnick, 1942; Kraya & Patrick, 1997; Silveira & Seeman, 1995; Vigo et al., 2019). In one study describing shared psychotic disorder in delusional parasitosis the most common diagnosis among inducers was organic mental disorder (Trabert, 1999).