Somatic sexual hallucinations and erotomanic delusions in a mentally handicapped woman

Abstract

ABSTRACT. A case of erotic delusion and concurrent somatic sexual hallucination is described in a 66‐year‐old mentally handicapped woman. The history, mental state and biological investigations convey the impression of erotomania, or de Clerambault's syndrome. Treatment with Pimozide has resulted in a remarkable improvement such that the patient has been symptom free for 8 months at the time of reporting. In the authors' opinion, the case lends support to the argument that erotomania exists as a mono‐delusional disorder and is equivalent to the DSM‐III‐R classification of Paranoid Disorder, Erotomanic Type.

Incubus Syndrome: A Case Series and Review of Literature

“…[ 6 ] We could additionally locate two case reports in Google search[ 8 9 ] and one possible case described as having erotomanic delusions with somatic sexual hallucinations. [ 10 ]…”

“…[ 7 ] In addition, we came across another case report in which authors described a patient with erotomanic delusions with somatic sexual hallucinations in an elderly woman. [ 10 ] Google search yielded few more case reports. In a case report from India, authors described the phenomenology of incubus in a patient with schizophrenia who required the use of electroconvulsive therapy.…”

Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma

“…From the 1940s onwards, various case reports and modest case series have been published on sexual hallucinations in the context of hypoparathyroidism ( 20 ), schizophrenia ( 21 – 24 ), mental retardation ( 25 ), narcolepsy ( 26 , 27 ), epilepsy ( 28 , 29 ), and the use of anesthetics ( 30 , 31 ). In the latter category, especially nitrous oxide has become a controversial substance because of its capacity to induce sexual hallucinations, and because of the alleged misuse of that knowledge by health professionals who made themselves guilty of actual sexual harassment while blaming their victims for their ignorance of the side-effects of nitrous oxide ( 32 ).…”

A romantic delusion: de Clerambault's syndrome in dementia

“…Impairments in functioning of spatial vision or lesions in the limbic system, especially in the temporal lobes, combined with ambivalent loving experiences and affective isolation, could contribute to delusional interpretations. In contrast, deficits in cognitive flexibility could contribute to maintenance of delusional beliefs (delusional content, however, would be determined by culture and personal experiences of each patient) 53,54 Adamou and Hale hypothesized that the increase in the responsiveness of postsynaptic D2/D3‐receptors in the mesolimbic system might be responsible for the emergence of the syndrome; 55 in fact, the mesolimbic system is linked with the development of psychosis and, specifically, when hyperactive to positive symptoms, such as hallucinations, delusions, and thought disorder 56 . Pearce, in describing his case of de Clerambault syndrome in association with folie a deux, adds the relative contributions of heredity and environment 57 …”