Delusions of Parasitosis: Psychotherapeutic Engagement

Torch, Evan M.; Bishop, Emmett R.

doi:10.1176/appi.psychotherapy.1981.35.1.101

Cited by 28 publications

(5 citation statements)

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“…There was complete remission of the delusion while receiving drugs in thirty cases (24 receiving pimozide, 3 receiving amitriptyline, and 3 receiving fluoxetine) and sixteen cases (receiving pimozide) showed partial improvement, while only six cases on pimozide did not show any improvement. Electroconvulsive therapy [19] and supportive psychotherapy [1,20] have also been suggested as modes of treatment in some cases, but in our series, these modes of management were not used.…”

mentioning

confidence: 82%

Delusional Parasitosis: A Clinical Profile

Bhatia

Jagawat

Choudhary

2000

Int J Psychiatry Med

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confidence: 82%

Delusional Parasitosis: A Clinical Profile

Bhatia

Jagawat

Choudhary

2000

Int J Psychiatry Med

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“…Some authors have used psychotherapy, with or without confrontational denial (40,320). It is helpful in 10% of cases, at best (346).…”

Section: Psychiatric Therapy Other Than Antipsychoticsmentioning

confidence: 99%

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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“…1 Skott, in a comprehensive review of 57 patients in 1978, described delusions of infestation as a symptom that could occur in 'almost any psychiatric context'. 2 The psychiatric literature contains detailed recommendations about dealing with these patients in psychotherapy, 3 but most dermatologists and many primary care physicians have neither the training nor the time for real psychotherapy or for making a precise psychiatric diagnosis.…”

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confidence: 99%