A Case Report of Body Dysmorphic Disorder and Illness Anxiety Disorder: Perspectives From DSM-5 and ICD-11.

ABSTRACT: Body dysmorphic disorder (BDD) is a mental illness currently classified as part of the "Obsessive-Compulsive and Related Disorders" (OCRD) chapter in both the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and in the ICD-11. This is not the case for illness anxiety disorder/hypochondriasis (IAD/HC), as IAD is classified in the chapter "Somatic Symptom and Related Disorders" in DSM-5, and in ICD-11, under the name HC, it is classified along with BDD in the OCRD chapter.In this article, we aim to describe a case of comorbid BDD and IAD/HC in a young adult Portuguese man. We then aim to review these diagnoses in light of their current classification in DSM-5 and ICD-11, with a particular emphasis in the divergent classification of IAD/HC, namely, the pertinence of its inclusion in the OCRD.

De Clérambault's syndrome revisited: a case report of Erotomania in a male.

BACKGROUND: Erotomania, also known as "de Clérambault's Syndrome", is a psychiatric syndrome characterized by the delusional belief that one is loved by another person of, generally of a higher social status. Erotomania has always been a target of attempts of conceptualization, and the utility of regarding Erotomania as an independent syndrome has been questioned to this day. Erotomania has a much higher prevalence in the female sex, and male Erotomania is a rare and probably underdiagnosed condition. Male Erotomania is only more prevalent in forensic samples, since male sex is one of the risk factors for violent behavior in this disorder. In this article, we aim to describe an uncommon case of Erotomania occurring in a male, hoping to add to literature and to reflect on the implications of the occurrence of Erotomania in men. By discussing the case in light of the different described clinical pictures, proposed diagnostic criteria and classifications, we also aim to contribute to the ongoing attempt to conceptualize this syndrome and to understand the pertinence of considering it an independent nosological entity. CASE PRESENTATION: We describe a case of Erotomania in a middle-aged Caucasian Portuguese male, with consecutive erotic delusions, followed by a classic turn to a persecutory delusion. The patient was admitted as an inpatient in a psychiatry unit and he was medicated with risperidone 3 mg and diazepam 3 mg daily. His persecutory delusion remitted a 4 days later, he gained insight and was discharged to follow-up as an outpatient. He retains his erotic delusional beliefs, but these are less intense, and has not presented further aggressive behavior. CONCLUSIONS: We can conclude that it seems reasonable to retain the operative concept of Erotomania as a subtype of Persistent Delusional Disorder/Delusional Disorder, since cases fitting the classical descriptions of the syndrome have been reported, including the presented case. The diagnosis of Erotomania has implications in case management, treatment and prognosis, and missing it, especially in men, may culminate in violent situations that can have legal implications. The developed diagnostic criteria and classifications seem to retain use and should be kept in mind, in the sense that they facilitate making an important diagnosis.