Delusions of Infestation

Hopkinson, G

doi:10.1111/j.1600-0447.1970.tb02106.x

Cited by 38 publications

(32 citation statements)

References 4 publications

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“…The Clinical Picture DI is very characteristic, and cases are often remembered by the treating practitioner (95,108,123,136,175). Despite its apparent uniformity and against common belief, DI is not a single psychiatric disorder (32,43,44,46,234,299,323).…”

Section: Delusional Infestationmentioning

confidence: 99%

“…Some simply report vermin, insects, parasites, or "small animals" (32,96,177,194,342). Other patients have more specific assumptions, e.g., (itch) mites/scabies (32,38,111,123,136,319,344), (pubic) lice (32,136,289,344), worms (32,136), bugs (200), fleas (194), flies, ticks (38), and spiders (136). Microscopic pathogens such as bacteria (289,342), viruses, and the like are reported much more rarely.…”

Section: The Imaginary Pathogensmentioning

confidence: 99%

“…Alleged infestations by some kind of inanimate material, such as hair (96,136), spots or dots (136), pigments, sand (123), threads, fibers, and the like, were rarities until the emergence of the "Morgellons phenomenon" in 2002. In a retrospective study of 385 published cases, patients reported the following pathogens, in decreasing order: insects, 84%; worms, 14%; bacteria, 2%; and fungi, 1% (323).…”

Section: The Imaginary Pathogensmentioning

confidence: 99%

“…The color of the pathogens is often black (32,136,194,342), gray, or white (250), but all colors occur. Sometimes they are supposed to be skin-colored (38) or even make color changes, e.g., from red to green (198,338).…”

Section: The Imaginary Pathogensmentioning

confidence: 99%

“…DI is characterized by patients' fixed belief that their skin and body (and rarely also their close personal environment) is infested by small, vivid (or less frequently inanimate) pathogens, although there is no medical or microbiological evidence for this. Most, but not all, patients blame the pathogens for causing various tactile sensations and itching (22,78,95,136,237). As a logical consequence of their belief, these psychiatric patients usually consult general practitioners, dermatologists, and microbiologists but are reluctant to see psychiatrists.…”

Section: Introductionmentioning

confidence: 99%

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Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

230

367

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SUMMARY This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practitioners but often lose faith in professional medicine. Epidemiology and history suggest that the imaginary pathogens change constantly, while the delusional theme “infestation” is stable and ubiquitous. Patients with self-diagnosed “Morgellons disease” can be seen as a variation of this delusional theme. For clinicians, clinical pathways for efficient diagnostics and etiology-specific treatment are provided. Specialized outpatient clinics in dermatology with a liaison psychiatrist are theoretically best placed to provide care. The most intricate problem is to engage patients in psychiatric therapy. In primary DI, antipsychotics are the treatment of choice, according to limited but sufficient evidence. Pimozide is no longer the treatment of choice for reasons of drug safety. Future research should focus on pathophysiology and the neural basis of DI, as well as on conclusive clinical trials, which are widely lacking. Innovative approaches will be needed, since otherwise patients are unlikely to adhere to any study protocol.

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Section: Delusional Infestationmentioning

confidence: 99%