Delusional infestation: an interface with psychiatry

Abstract

SUMMARY Delusional infestation (delusional parasitosis) is a relatively rare condition but it has been of interest to a wide range of professionals, including entomologists, zoologists and dermatologists, as patients predominantly seek help from specialties other than psychiatrists. The illness requires a multidisciplinary approach and a strong bond of trust between the treating clinician and the patient to ensure the best possible outcome. This article discusses how clinicians in all specialties should approach patients presenting with the disorder and outlines differential diagnosis and associated laboratory tests. It considers the evidence base for treatment and the success of psychodermatology clinics that provide a ‘neutral setting’ for consultation to address the problem of patients’ non-engagement. Such clinics are few, and there is a need to develop disease-specific pathways in primary care and hospital settings to improve prognosis.

Delusional Infestation: A case of Ekbom syndrome in an elderly woman with a long history of HIV

“…2 Patients usually decline psychiatric treatment and are treated mainly by non-psychiatric experts, particularly dermatologists, for several years before psychiatric evaluation. 3 Females are more affected than males; the peak onset age is after 50 years, 4 although may occur even in younger age groups. 5 HIV is an independent risk of Ekbom syndrome and psychiatric comorbidities, including depression, anxiety, bipolar disorders, adjustment disorders, and HIVassociated neurocognitive disorders.…”

“…Patients usually decline psychiatric treatment and are treated mainly by non‐psychiatric experts, particularly dermatologists, for several years before psychiatric evaluation 3 . Females are more affected than males; the peak onset age is after 50 years, 4 although may occur even in younger age groups 5 …”

Delusional Infestation: A case of Ekbom syndrome in an elderly woman with a long history of HIV

“…Patients usually decline psychiatric treatment and are treated mainly by non-psychiatric experts, particularly dermatologists, for several years before psychiatric evaluation (3). Females are more affected than males (4) and the peak age of onset ranges from 55 to 68 years.…”

Cogito, ergo praedico(I think, therefore I predict)

“…In their overview on delusional infestation in the current issue of the BJPAdvances , Waykar and colleagues summarise the approach to delusional infestation and the interaction of psychiatrists with other specialties (Waykar 2021). They identify engaging and communicating with a patient who has delusions as a major challenge for clinicians.…”