ABSTRACT
Introduction: Delusional parasitosis (DP) is a form ofmonohypochondriacalpsychosis characterized by a feelingthat there are parasites crawling beneath the skin and is seen inrarely in psychiatric or primary carepractice. The disorder haspoor prognosis with a varied course and multiple relapses. Thepresent paper reports an analysis of 177 cases of delusionalparasitosis seen in a tertiary general hospital over the last 11years.Material and methods: The present study is an analysis of177 cases of DP that presented to the psychiatry departmentof a tertiary general hospital over the past 11 years and thedata has been analyzed using a semi-structured proforma anddescriptive statistics.Results: The mean age of the sample was 34.6 ± 21.3 yearsand the mean age of onset of the disorder was 28.3 ± 17.1years. The mean duration of illness of the sample was 3.9 ±10.3 years. 103 (58.19%) had a magnetic resonance imagingof the brain done which was within normal limits. 56(31.63%) patients had repeated neuroimaging investigationslike EEG, MRI and CT Scans done which were also all withinnormal limits. Most patients were treated with Risperidoneand Aripiprazole while few were treated with Pimozide,Haloperidol and Amisulpride. 43 (24.29%) patients received acourse of electroconvulsive therapy (ECT) as well in additionto medications.Conclusion: DP though rare is seen in clinical practice andfurther longitudinal studies are needed to establish withgreater certainty facts about the course and prognosis of thedisorder
ABSTRACT
BACKGROUND: Delusions of parasitosis (DOP) is a psychiatric disorder in which patients have a fixed, false belief that they are infested by parasites. Management of patients with DOP presents a challenge to dermatologists, because such patients usually refuse to see a psychiatrist. OBJECTIVE: The aim of this study was to investigate the clinical manifestations and responses to treatment in DOP patients. METHODS: Between January 2010 and December 2012, the medical records of 32 DOP patients were reviewed to obtain data on clinical presentation, family history, accompanied psychiatric disorders, and treatments. RESULTS: The male-to-female ratio was 1:4.3. Twenty-two patients (68.8%) had symptoms for over 6 months. Seven patients (21.9%) had apparent skin lesions. Eighteen patients (56.3%) had a positive specimen sign. Three patients had depression, 4 had insomnia, and 2 had other delusional disorders. Eight patients (25%) reported that their family members were also experiencing itching. Six patients underwent skin biopsies, the results of which were consistent with chronic dermatitis. With pimozide treatment, 6 patients (18.8%) achieved complete remission, 17 (53.1%) showed a partial response, and 9 (28.1%) showed no response. CONCLUSION: Because DOP patients depend on dermatologists for treatment, it is crucial for dermatologists to be prepared for the proper management of this condition. This study expands our understanding of the disease and suggests the optimal methods of treatment. Further studies on socioeconomic data and selection of effective antipsychotics are needed.
Subject(s)
Humans , Antipsychotic Agents , Biopsy , Delusions , Depression , Dermatitis , Dermatology , Medical Records , Parasites , Pimozide , Pruritus , Psychiatry , Retrospective Studies , Schizophrenia, Paranoid , Skin , Sleep Initiation and Maintenance DisordersABSTRACT
OBJECTIVE:To investigate the effect of STAT5 pathway inhibitor pimozide on the expressions of nitric oxide (NO)and nitric oxide synthetase(iNOS)in the model of mouse macrophage RAW264.7 inflammation induced by lipopolysaccha-ride (LPS). METHODS:RAW264.7 cells in logarithmic growth phase were divided into blank control group,drug control group (10μmol/L pimozide),model group(1μg/ml LPS)and the pimozide groups of low,middle and high doses(2.5,5 and 10μmol/L), where the corresponding cells were given pimozide 30 min before the administration of LPS,and then were cultured for 24 h. Griess method was used to determine the content of NO in the supernate of cell culture solutions of all groups,real-time quantita-tive polymerase chain reaction(RT-PCR)to determine iNOS mRNA expression,and Western blot method to determine the protein expression of iNOS and phosphorylated STAT5(p-STAT5). RESULTS:The content of NO,iNOS mRNA and protein expressions and the content of p-STAT5/STAT5 in the cells in the model group were higher than those in the blank control group,with statisti-cally difference (P<0.01). Compared to the model group,the pimozide groups of middle and high doses had lower content of NO,iNOS mRNA and protein expressions and the content of p-STAT5/STAT5 in the cells,with statistically difference(P<0.01 or P<0.05). CONCLUSIONS:STAT5 pathway inhibitor pimozide can inhibit the release of NO by inhibiting iNOS mRNA and pro-tein expressions in cells.
ABSTRACT
En el presente trabajo se da cuenta de la historia del síndrome delirante crónico conocido como "delirio de parasitosis o síndrome de Ekbom", sus principales características clínicas, evolutivas, la ubicación nosográfica y las estrategias terapéuticas utilizadas. Los hallazgos de la principal literatura publicada se comparan con la experiencia de los autores al haber estudiado doce pacientes portadores de esta sintomatología. Asimismo, se indaga acerca de la posible conexión con otros cuadros psicopatológicos, más específicamente con el espectro obsesivo-compulsivo.
In this paper, the history of the chronic delusional syndrome known as delusional parasitosis or Ekbom syndrome is reviewed as well as its main clinical characteristics, evolution, nosographic position and therapeutic approaches. The findings in the published literature are compared with the clinical experience of the authors who have studied twelve cases. The possible connection with other mental diseases, specifically Obsessive Compulsive Spectrum, is evaluated.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Delusions/psychology , Parasitic Diseases , Restless Legs Syndrome , Delusions/diagnosis , Delusions/therapy , Pimozide , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/therapyABSTRACT
Se estudiaron diferentes formulaciones de tabletas de pimozida en dosis de 1 y 4 mg, diseñadas con el objetivo de obtener una formulación que cumpla con los parámetros establecidos en la Farmacopea de los Estados Unidos XXII para el control de la calidad del producto terminado, así como los requerimientos necesarios para su revestimiento. Entre las formulaciones establecidas la denominada PP cumplió con los parámetros de calidad establecidos, antes y posterior al revestimiento. Los resultados obtenidos en el estudio de vida en estante de las tabletas revestidas fabricadas a escala semiindustrial demostraron que hasta 1 año posterior a la fabricación, éstas cumplen con las especificaciones establecidas en la Farmacopea, lo cual soporta la factibilidad para su escalado al nivel industrial.
Different formulations of Pimozide 1 and 4 mg tablets designed to obtain a formulation that meets the parameters established by the United States Pharmacopeia XXII for controlling the quality of the finished product, as well as the necessary requirement for its coating, were studied. Among these formulations, the so-called PP fulfilled the established quality parameters before and after coating. The results obtained in the shelf life study of the coated tablets made at semiindustrial scale showen that even one year after their making they meet the specifications established by the Pharmacopeia, which supports the feasibility for their scale-up at industrial level.
ABSTRACT
Delusions of parasitosis is a type of monosymptomatic hypochondrial psychosis and is defined as the fixed belief that one is infested with living organisms, in t.he abscence of any objective evidence that such infestation exists. A 43 year-old woman had a 2-month history of generalized pruritus and skin ulceration on the buttock representing dermatitis artefacta. She also complained of seeing small black insects crawling on her whole body skin, especially on the pubic area without evidence of cutaneous invasion by the parasites. She had no evidence of other medical diseases. She was treated with oral pimozide, starting with 1mg/day to 3mg/day. In two weeks, clinical symptoms and false belief that she is infested with parasites subsided.
Subject(s)
Adult , Female , Humans , Buttocks , Delusions , Dermatitis , Insecta , Parasites , Pimozide , Pruritus , Psychotic Disorders , Skin , Skin UlcerABSTRACT
We report a case of 64-year-old female patient who has had factitious skin lesions for 20 years. She complained formification sense and severe itching on her face. These symptoms were improved with squeezing and bleeding. There were scuare shaped ulcerated nodule on the right cheek and white depressed scar on the left cheek. She was treated with wet dressing and occlussive dressing, and skin lesions were nearly cleared within 3 weeks, but new lesion appeared. Pimozide 2mg #1 p.o were given under the diagnosis of delusion of parasitosis from June, 1984. Her symptoms were improved without recurrence till now. Treatment with pimozide in monosymptomatic hypochondriacal syndrome is discussed.