ABSTRACT
The case of a 42-year-old woman with delusional disorder, somatic type (DDST), with infestation delusion and delusions of body odor and halitosis accompanied by severe secondary depression is presented. These somatic delusions and depressive symptoms responded favorably to treatment with paroxetine 10 to 30 mg/d. Hypoperfusion in the left temporal and parietal lobes observed when she had marked clinical symptoms was improved at near recovery. The present report suggests that paroxetine is effective and a reasonable drug for DDST with secondary depression. It also supports previous observations that DDST is associated with hypoperfusion in the temporal and parietal lobes.
Subject(s)
Antidepressive Agents, Second-Generation/therapeutic use , Depression/complications , Depression/drug therapy , Paroxetine/therapeutic use , Schizophrenia, Paranoid/complications , Schizophrenia, Paranoid/drug therapy , Adult , Antidepressive Agents, Second-Generation/pharmacology , Depression/pathology , Female , Humans , Magnetic Resonance Imaging , Parietal Lobe/drug effects , Paroxetine/pharmacology , Psychiatric Status Rating Scales , Schizophrenia, Paranoid/pathology , Severity of Illness Index , Temporal Lobe/drug effectsABSTRACT
A 54-year-old man with delusional disorder, somatic type (DDST) showed extremely grotesque somatic delusions, i.e., the presence of another lower jaw with teeth and tongue accompanied by annoying sensations. These somatic delusions responded favorably to treatment with risperidone 2-3 mg/day. The single photon emission computed tomography taken when he had marked somatic delusions showed hypoperfusion in the temporal and parietal lobes. The present report suggests that delusion of reduplication of body parts, which has been generally associated with organic brain diseases, is also observed in DDST. This report also supports prior observations on the efficacy of risperidone for DDST and the association between this disorder and hypoperfusion in the temporal and parietal lobes.
