An approach to the treatment of psychogenic parasitosis

Zanol, Karen; Slaughter, James R.; Hall, Robert D.

doi:10.1046/j.1365-4362.1998.00159.x

Cited by 41 publications

(37 citation statements)

References 21 publications

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“…Still, well-informed patients with DI will argue that new infectious agents are discovered continuously and that patients have falsely received a diagnosis of DI and eventually turned out to be truly infested. We are aware of 13 cases of this kind in the medical literature (n ϭ 1 [328], n ϭ 6 [192], n ϭ 2 [351], with 1 of them reported twice [77], n ϭ 1 [119], n ϭ 1 [73], and n ϭ 2 [280]). In terms of figures, based on at least 1,400 published cases of DI (conservative estimate of prevalence), the risk of overlooking an infestation would be less than 1%.…”

Section: Inset 14 Defining Delusionsmentioning

confidence: 99%

“…Most authors recommend a graded pathway with two major steps for optimized clinical management of patients with DI (76,234,280,351). It has to be stressed, however, that all of these clinical pathways for DI have not been evaluated in terms of sensitivity, specificity, or cost-efficiency and represent expert opinion only.…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

“…Obviously, the patient has to be informed that in his or her case, the substance chosen is not indicated for schizophrenia, but antipsychotics generally are used for many indications other than schizophrenia. In desperate cases, even a bargain might be indicated (further examination and diagnostic investigations for accepting a treatment trial) (351).…”

Section: Inset 17 Do's and Don'tsmentioning

confidence: 99%

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Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

235

367

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SUMMARY This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practitioners but often lose faith in professional medicine. Epidemiology and history suggest that the imaginary pathogens change constantly, while the delusional theme “infestation” is stable and ubiquitous. Patients with self-diagnosed “Morgellons disease” can be seen as a variation of this delusional theme. For clinicians, clinical pathways for efficient diagnostics and etiology-specific treatment are provided. Specialized outpatient clinics in dermatology with a liaison psychiatrist are theoretically best placed to provide care. The most intricate problem is to engage patients in psychiatric therapy. In primary DI, antipsychotics are the treatment of choice, according to limited but sufficient evidence. Pimozide is no longer the treatment of choice for reasons of drug safety. Future research should focus on pathophysiology and the neural basis of DI, as well as on conclusive clinical trials, which are widely lacking. Innovative approaches will be needed, since otherwise patients are unlikely to adhere to any study protocol.

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Section: Inset 14 Defining Delusionsmentioning

confidence: 99%

Section: Diagnostic Proceduresmentioning

confidence: 99%

Section: Inset 17 Do's and Don'tsmentioning

confidence: 99%

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Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

235

367

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“…Under the results of this case and information in the literature (14)(15)(16), it may be claimed that low dose atypical antipsychotics may be a good treatment option for patients with delusional parasitosis. Treatment response should be waited patiently, and doses should be increased gradually in consistence with the age will be helpful to increase patient compliance with the treatment.…”

Section: Discussionmentioning

confidence: 78%

“…When the literature related to delusional parasitosis treatment was reviewed, it was noted that case presentations which responded to antipsychotic treatment such as haloperidol, pimozid, trifluperazin, and risperidone were reported (11,(14)(15)(16). In recent years, as extrapyramidal and cardiovascular side effects of typical antipsychotics have been considered, treatment preferences have been more frequently for atypical antipsychotics (15). Although the treatment duration is still debatable, it requires 1-4 weeks for treatment response.…”

Section: Discussionmentioning

confidence: 99%

A delusional parasitosis case responding to low dose risperidone treatment

Yüksel¹,

Kotan²,

Aksoy³

et al. 2016

Dusunen Adam

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A delusional parasitosis case responding to low dose risperidone treatment Delusional parasitosis is a somatic type delusional disorder encountered in presenile women who suffer from a fixed false belief that they are infested with parasites. Despite a detailed examination and assurance, patients are not convinced that they have no parasitic infection. Repetitive applications and tests increases the treatment cost very much. In this article, we present a 76 years-old woman who had persistent thoughts about being infested by parasites for two years, and made deep scars widely distributed on her body, and was refusing any psychiatric diagnosis. Our aim was to draw attention to the delusional disorder which was a rare disease with poor prognosis, and to report results of low dose risperidone treatment with favorable outcomes of given psycho-education to the patient and her family.Keywords: Delusional disorder, delusional parasitosis, parasite delusion ÖZET Düşük doz risperidon tedavisine yanıt veren delüzyonel parazitoz vakasıDelüzyonel parazitoz, genellikle ileri yaş kadınlarda görülen, hastaların parazitlerle enfekte olduklarına yönelik sabit bir yanlış inanca sahip oldukları somatik tip bir delüzyonel bozukluktur. Kendilerine detaylı açıklamalar yapılıp, bir parazit enfeksiyonu olmadığına yönelik güvence verilmesine rağmen, hastalar ikna olmazlar.Tekrarlayan uygulamalar ve tetkikler, tedavi maliyetini oldukça arttırır. Bu makalede, 76 yaşında, 2 yıldır delüzyonel parazitozu olan, vücudunun parazitlerce istila ettiğini düşünen, bu parazitleri çıkarma isteğiyle vücudunda derin yaralar açan ve psikiyatrik hastalığı olduğunu reddeden bir kadın hastayı sunuyoruz.Amacımız, nadir görülen, dirençli ve kötü prognozlu bir gidişe sahip olan delüzyonel bozukluğa dikkat çekmek ve düşük doz risperidon tedavisi ile hasta ve aileye verilen psiko-eğitimin olumlu sonuçlarını bildirmektir.Anahtar kelimeler: Delüzyonel bozukluk, delüzyonel parazitoz, parazit delüzyonu

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