Psicopatologia - Delusional parasitosis a till today not sufficiently know psychiatric syndromre

RESUMO

The most important contribuitions on delusional parasitosis or tactile hallucionosis are by means of the findings in an own sample of 36 patients critically reviewed. Although from a review of the literature, comprising about 500 cases in more than 250 papers, seems to emerge a rather homogeneous picture of the disorder, the views on some clinical data, freqency, age on onset, course, prognosis, nosological classification, underlyng illnesses and pathogenesis are partly different and controversial. It is shown that the syndrome is until today not sufficiently know in psychiatry, above all because the great majority of the patients do not search for psychiatric help. The patients are female more often than male (2.3-1 in the own sample), between 25 and 84 years of age, but in 81 per cent beginning after the age of 50. The onset is in 19 per cent of the own sample, and here exclusively in endogenous psychoses, before the age of 50. As to the nosological classification, the delusional parasitosis develops in the half of the Bonn sample in the course of endogenous, maainly schizophrenic psychoses, in the other half based on organic (cascular) brain diseases. In endogenous psychoses the course is mainly in phases and not chronic or progressing as reported by BERS and CONRAD. The observation of the course speaks for the assumption that qualitatively abnormal bodily sensations, i.e. level-2-cenesthesias, often preceding in long prodomes the proper tactile hallucinosis, are an essential component in the pathogenesis of the syndrome. These sensations are psychopathologically the same bodily experiences that occur in many schizophrenic course and, as dominating symptomatology, in the cenesthetic type of schizophrenia