Delusional infestation may be caused by recreational drug usage in some patients, but they may not disclose their habit

Abstract

This study indicates that the prevalence of recreational drug use in patients with DI is high, and that patients do not always disclose their habit. It is hoped that this pilot study will lead to further research into this finding.

Management of delusions of parasitosis: an interview with experts in psychodermatology

“…Moreover, a diagnosis of primary DI can only be made after excluding all other possible causes including primary skin infections (e.g., scabies, mites), underlying neurologic disease (head injury, dementia, vitamin B12 deficiency), medical conditions (e.g., hyperthyroidism, liver disease), psychiatric conditions (e.g., schizophrenia), medication side effects (dopamine agonists), or substance use/withdrawal (amphetamines, cocaine, alcohol). 7 Finally, underlying psychiatric disorders such as schizophrenia, must also be excluded. 8 Ideally, this is often best achieved through evaluation by other providers, including medicine, neurology, and psychiatry.…”

“Doctor, You Must Examine My Creature Collection!”: A Case Report of Delusional Infestation

“…Therefore, based on the considerable overlap of the disorders--especially with regard to successful management with psychiatric drug therapy--many investigators favor Morgellons disease to be a subtype of delusional infestation [15][16][17][18]. Numerous associated diseases have been observed in patients with a delusional infestation (Table 1) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Indeed, in this setting, the disease-associated manifestations in some of the affected patients with secondary delusional infestation resolved when the primary condition was treated.…”

“…Secondary delusional infestation results from either an underlying medical condition, a systemic medication, or an illicit drug; treatment is directed toward the associated etiology. Once the secondary delusional infestation is excluded, the patient is diagnosed with primary delusional infestation; for these individuals, treatment often requires antipsychotic pharmacologic intervention [7][8][9][10][11][12][13][14].…”

Management of the psychological comorbidities of dermatological conditions: practitioners' guidelines

“…Ruling out these triggering factors is important, as only primary DI (caused by true delusion/psychosis) is treated with antipsychotics, whereas secondary DI (that which has an organic basis) is treated by addressing the underlying issue. Ruling out substance abuse may require more than simply asking the patient whether they use drugs, as substance abuse seems to be quite prevalent in this patient population, and they do not always openly disclose the habit 100. As a result, routine urine drug screens may be recommended for new patients with DI, even if they deny drug use 64,100…”

“…Ruling out substance abuse may require more than simply asking the patient whether they use drugs, as substance abuse seems to be quite prevalent in this patient population, and they do not always openly disclose the habit 100. As a result, routine urine drug screens may be recommended for new patients with DI, even if they deny drug use 64,100…”