Depersonalization is discussed and a brief outline of the primary symptoms is presented. The relationship between obsessionalism and depersonalization is reviewed in the literature, and subsequent similarities are presented. The intellectual obsessive depersonalization syndrome is postulated as a variant, and also as an exposition of what might occur in many other cases of depersonalization. Finally, a picture is presented which takes into account a strong component of obsessionalism in both the etiology and course of depersonalization.
As with many psychiatric syndromes, there are multiple etiological factors which seem to play a role in the development of delusions of parasitosis. Our case report suggests that a psychotherapeutic approach may prove valuable in treatment. Acaraphobic and other monosymptomatic hypochondriacal patients, despite an extreme defensive stance, will adhere to and cooperate with a therapeutic process which enables them to voice psychic pain without challenging the validity of a somatic complaint. In finally sharing feelings of deprivation and hurt, the patient can, with some additional rather "concrete" advice, proceed to a point where he no longer must prove the legitimacy of his complaint. By the very nature of this freedom, he can then work with the therapist in a meaningful, rather than stalemated, psychotherapeutic process.
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