Delusional parasitosis on the psychiatric consultation service – a longitudinal perspective: Case study

Trenton, Adam; Pansare, Neha; Tobia, Anthony; Bisen, Viwek; Kaufman, Kenneth R.

doi:10.1192/bjpo.bp.116.004358

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Parasitosis can afflict patients for days to decades, with an average duration of three years [5]. Seventy-four percent of delusional parasitosis occurs in patients with a history of depression [5,6]. When patients misconstrue a real item with a false pathogen, the psychopathology could be classified as an illusion instead of a hallucination; this can worsen for patients with impaired vision [5,7].…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Perspective Case Study of Delusional Parasitosis in a Geriatric Psychiatry Unit

Suparmanian,

Cardona

2023

Cureus

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Delusional parasitosis is not a common presentation in hospital-based geriatric units. Our aim was to review the presentation of a sudden onset of parasitosis in an older patient who had no prior psychiatric history, and its management. This case report describes an 82-year-old man who presented with delusions of parasitosis for the past three years of his life. The report includes a longitudinal description of the patient's symptoms, signs, and manifestations during his stay at an inpatient senior mental health service center, emergency department (ED) visits, and medical floor stay along with medication management of his psychiatric symptoms with concomitant medical issues. Presentation of delusional parasitosis poses a special challenge not only psychiatrically but also medically and dermatologically. The unique difficulty of finding appropriate antipsychotics for not only the symptoms of parasitosis but also the compulsive behavior that follows a deeply ingrained belief of being infested must be carefully managed, especially in the elderly. Somatic delusions that resemble a plausible but inaccurate reality of infestations could delay treatment as well.

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Section: Discussionmentioning

confidence: 99%

A Longitudinal Perspective Case Study of Delusional Parasitosis in a Geriatric Psychiatry Unit

Suparmanian,

Cardona

2023

Cureus

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“…More than half of the patients with DP have a history of depression; therefore, both diseases may occur simultaneously. There are individuals for whom DP appears to cause depression and patients for whom depression appears to precipitate DP [52]. A very small number of patients with DP can recover without therapy [53].…”

Section: Clinical Aspects Of Dpmentioning

confidence: 99%

Insights into the Medical Evaluation of Ekbom Syndrome: An Overview

Mindru,

Radu,

Bumbu

et al. 2024

IJMS

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Ekbom syndrome, also known as delusional parasitosis (DP) or delusional infestation, is an uncommon psychiatric disorder distinguished by an enduring conviction of parasitic infestation, persisting notwithstanding the presence of medical evidence to the contrary. Primarily affecting middle-aged women, DP can manifest either as isolated psychological distress or as a component within a more intricate psychiatric framework, substantially influencing the quality of life for affected individuals. Its pathophysiological mechanism involves uncertain dopaminergic imbalances and dysfunction in the dopamine transporter system. Dermatologists often play a pivotal role in diagnosis, as patients first seek dermatological assessments of their signs and symptoms. However, DP frequently originates from underlying psychiatric disorders or medical variables, manifesting with neurological and infectious causative factors. The diagnostic complexity is attributed to patients’ resolute convictions, leading to delayed psychiatric intervention. First-line DP treatment involves antipsychotics, with newer agents demonstrating promising prospects, but the lack of standardized protocols poses a significant therapeutic challenge. In this narrative review, both a comprehensive approach to this uncommon pathology and an update on the state of knowledge in this medical subfield focused on optimizing the management of DP are provided. The complexity of DP underlying its uncommon nature and the incomplete understanding of its pathophysiology highlight the need for further research through multicenter studies and multidisciplinary teams to enhance therapeutic efficacy and safety.

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“…Delusional parasitosis, which is characterized by a fixed and persistent belief of having a pathogenic infection despite objective evidence to the contrary, is more common in dermatology rather than psychiatry [7]. It presents the distinction between primary and secondary delusional parasitosis; the former cannot be explained by any other condition, the latter can result from psychiatric disorders, substances of abuse, medication, and general medical conditions including organic brain disease such as dementia [8].…”

Section: Introductionmentioning

confidence: 99%

Delusional parasitosis in dementia with Lewy bodies: a case report

et al. 2019

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BackgroundDementia with Lewy bodies (DLB) is characterized by fluctuating cognitive impairments, recurrent visual hallucinations, the motor symptoms of parkinsonism and REM sleep behavior disorder. Various neuropsychiatric symptoms including hallucination and delusions occur frequently; however, delusional parasitosis is rare in DLB. Here, we report a case of DLB patient with delusional parasitosis.Case presentationThe patient was an 89-year-old woman. At the age of 88, she began to complain her oral cenesthopathy, and developed cognitive decline, delusional parasitosis and parkinsonism. As a result of examination, she was diagnosed as DLB and treated with combination of donepezil 5 mg/day and aripiprazole 1.5 mg/day, and her complaint was disappeared.ConclusionsFurther studies are needed to investigate the association between delusional parasitosis and underlying pathophysiology of DLB, and the utility of antipsychotics for delusional parasitosis in DLB has to be examined through more cases.

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Delusional parasitosis on the psychiatric consultation service – a longitudinal perspective: Case study

Cited by 5 publications

References 22 publications

A Longitudinal Perspective Case Study of Delusional Parasitosis in a Geriatric Psychiatry Unit

A Longitudinal Perspective Case Study of Delusional Parasitosis in a Geriatric Psychiatry Unit

Insights into the Medical Evaluation of Ekbom Syndrome: An Overview

Delusional parasitosis in dementia with Lewy bodies: a case report

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