Refractory Delusional Parasitosis in a 70-year-old Woman

D'Auria, Anthony; Wiseman, Taylor; Varghese, Anjali; Espiridion, Eduardo D

doi:10.7759/cureus.3120

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…This conclusion awaits confirmation by further research. A case report of a 70-year-old woman with delusional parasitosis and cognitive decline [ 24 ], followed in an outpatient Partial Psychiatric Hospitalization Program (PPHP), is consistent with this view. Microvascular ischemic changes and cortical atrophy were associated with a poor response to treatment with the antipsychotic, olanzapine, and the antidepressant venlafaxine.…”

Section: Collaboration With Neurologistsmentioning

confidence: 71%

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

et al. 2022

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Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists. Methods: A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients. Results: Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry. Conclusions: This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.

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Section: Collaboration With Neurologistsmentioning

confidence: 71%

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

et al. 2022

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“…A comprehensive recommendation for healthcare practitioners would involve a meticulous consideration of individual patients' characteristics, encompassing pertinent medical comorbidities, alongside a discerning evaluation of the respective side effect profiles and safety parameters inherent to each antipsychotic agent. Such a judicious approach to the selection of antipsychotics is imperative in order to optimize therapeutic outcomes while minimizing potential adverse effects [90,91]. Table 2 provides a brief overview of antipsychotics that can be used for the therapeutic management of DP.…”

Section: Therapeutic Managementmentioning

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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“…This case, however, strongly suggests a clinical trial of brain imaging at the onset of delusions in DD to determine potential associations with structural brain impairment. D'Auria and collaborators [24] report the case of a 70-year-old woman who had run away from home, her explanation being that she was a burden to her family because of a long-standing parasite infestation. This delusional belief had begun 15 years previously and had occasioned two previous hospitalizations.…”

Section: Relationship Of Brain Structure Cognition and Treatment Resp...mentioning

confidence: 99%

Delusional Disorder in Old Age: A Hypothesis-Driven Review of Recent Work Focusing on Epidemiology, Clinical Aspects, and Outcomes

González-Rodríguez

Seeman

Izquierdo

et al. 2022

IJERPH

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The theme, strength, and duration of a delusion are considered important in distinguishing one psychosis of old age from another. Research results, however, are mostly based on studies conducted on one form of psychosis, namely schizophrenia. The aim of this hypothesis-driven narrative review is to gather clinically important information about the psychosis identified as delusional disorder (DD), as it affects persons of senior age. We hypothesized that DD becomes relatively prevalent in old age, especially in women; and that it is associated with demonstrable brain changes, which, in turn, are associated with cognitive defects and poor pharmacological response, thus increasing the risk of aggression and suicide. Computerized searches in PubMed and ClinicalTrials.gov were conducted using the following search terms: (delusional disorder) AND (elderly OR old OR aged OR psychogeriatrics). A total of 16 recent studies (including case reports) were reviewed. Our hypotheses could not be definitively confirmed because research evidence is lacking. In order to improve eventual outcomes, our literature search demonstrates the need for more targeted, well-designed studies.

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Refractory Delusional Parasitosis in a 70-year-old Woman

Cited by 5 publications

References 11 publications

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders

Insights into the Medical Evaluation of Ekbom Syndrome: An Overview

Delusional Disorder in Old Age: A Hypothesis-Driven Review of Recent Work Focusing on Epidemiology, Clinical Aspects, and Outcomes

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