De Clérambault’s syndrome revisited: a case report of Erotomania in a male

Abstract

Background Erotomania, also known as “de Clérambault’s Syndrome”, is a psychiatric syndrome characterized by the delusional belief that one is loved by another person of, generally of a higher social status. Erotomania has always been a target of attempts of conceptualization, and the utility of regarding Erotomania as an independent syndrome has been questioned to this day. Erotomania has a much higher prevalence in the female sex, and male Erotomania is a rare and probably underdiagnosed condition. Male Erotomania is only more prevalent in forensic samples, since male sex is one of the risk factors for violent behavior in this disorder. In this article, we aim to describe an uncommon case of Erotomania occurring in a male, hoping to add to literature and to reflect on the implications of the occurrence of Erotomania in men. By discussing the case in light of the different described clinical pictures, proposed diagnostic criteria and classifications, we also aim to contribute to the ongoing attempt to conceptualize this syndrome and to understand the pertinence of considering it an independent nosological entity. Case presentation We describe a case of Erotomania in a middle-aged Caucasian Portuguese male, with consecutive erotic delusions, followed by a classic turn to a persecutory delusion. The patient was admitted as an inpatient in a psychiatry unit and he was medicated with risperidone 3 mg and diazepam 3 mg daily. His persecutory delusion remitted a 4 days later, he gained insight and was discharged to follow-up as an outpatient. He retains his erotic delusional beliefs, but these are less intense, and has not presented further aggressive behavior. Conclusions We can conclude that it seems reasonable to retain the operative concept of Erotomania as a subtype of Persistent Delusional Disorder/Delusional Disorder, since cases fitting the classical descriptions of the syndrome have been reported, including the presented case. The diagnosis of Erotomania has implications in case management, treatment and prognosis, and missing it, especially in men, may culminate in violent situations that can have legal implications. The developed diagnostic criteria and classifications seem to retain use and should be kept in mind, in the sense that they facilitate making an important diagnosis.

Same Gender De’ Clerambault in a Man: Case Report

“…In this case, the patient is administered antipsychotics in the form of risperidone, where this treatment is proven to be useful in reducing the intensity of delusion and controlling behavior. Risperidone at doses below 6 mg/day is the first line of therapy, and pure/primary erotomania responds best to neuroleptic treatment [11].…”

Gegenwärtige Aspekte des Liebeswahns

“…In weniger als der Hälfte der Fälle kam es zu Übergriffen und Belästigungen der Wahnobjekte [16]. Valadas und Bravo wiesen allerdings ausdrücklich auf das Risiko von Delinquenz, insbesondere seitens männlicher Erkrankter, hin [17]. Letztendlich besteht Übereinstimmung darüber, dass eine genaue Genese des primären Liebeswahns bisher unverstanden ist.…”

Same Gender Erotomania: When the Psychiatrist Became the Delusional Theme—A Case Report and Literature Review

“…The incidence of delusional disorder is rare, estimated to be around 1 to 3 cases per 100,000 population [ 1 ], with erotomania-subtype being much rarer [ 2 ]. Erotomania refers to the persistent delusional belief that another person, usually of someone with higher socio-economic status, is in love with the affected person, despite having little or no contact [ 3 , 4 ].…”