Delirio de parasitosis en la esclerosis múltiple: una expresión enigmática de una enfermedad pleomórfica / Delusional parasitosis in multiple sclerosis: An enigmatic manifestation of a multifaceted disease

No disponible

Delusional infestation in psychodermatology.

Delusional infestation (DI), also known as delusional parasitosis, consists of a patient's strong belief that he or she is infested with a nonliving substance or living organism despite lack of medical evidence to support this belief. The most commonly reported sources of infestation include insects, fibrous strands, worms, and scabies. DI is predominantly seen in women and older patients. This disorder has a variable course and prognosis in patients. DI can be a primary psychiatric problem, or secondary to underlying medical conditions or other psychiatric disorders. It has been proposed that DI presents along a spectrum that includes four categories: overvalued concern of infestation, somatoform preoccupation, delusional state, and terminal delusional state. Management depends on the patient's category at presentation. The diagnostic approach for DI involves a thorough evaluation that can rule out medical conditions that underlie the patient's symptoms. This includes obtaining a detailed history, physical exam, and ordering laboratory tests. Treatment for primary DI includes both first and second-generation antipsychotics. Secondary DI treatment depends on the etiology. The prognosis of patients with DI is difficult to predict due to various factors including level of insight, underlying psychiatric conditions, and medication adherence. It is important for the physician to maintain a therapeutic relationship with the patient in order to properly address the patient's concerns.

Folie a deux and delusional disorder by proxy: an atypical presentation.

Delusion of parasitosis is a rare condition characterised by an individual harbouring the delusion of being infested with insects or parasites. We report a rare and interesting case of delusion of parasitosis presenting as folie a deux, that is, the delusion is shared by both the parents of an 18-month-old child, with proxy projection of parental delusion on the child. The case highlights the rare concomitant occurrence of two psychocutaneous disorders and emphasizes the importance of early recognition and appropriate intervention to safeguard the well-being of the child.

[Nosographic considerations on delusional parasitosis based on three clinical observations]. / Considérations nosographiques sur le délire d'infestation parasitaire à travers trois observations cliniques.

Ekbom syndrome or delusional parasitosis is a rare disease characterized by the unwavering conviction of having cutaneous infestation of insects or parasites. This is a monothematic delusion of hallucinatory origin that typically affects older women. We report the case of three patients with delusional parasitosis in different clinical settings. The first patient suffered from isolated delusional parasitosis corresponding to the condition described by Karl Ekbom. The second case suffered from secondary delusional parasitosis, occurring in the setting of leukoencephalopathy (CADASIL). Lastly, the third patient appeared in a state which was evocative of a depressive episode with psychotic symptom integrating delusional parasitosis. These three clinical vignettes perfectly illustrate the trans-nosographic dimension of this syndrome and the difficulties in treating these patients, both in terms of therapeutic alliance and of choice of pharmacological treatment.

Uncommon and/or bizarre features of dementia.

This study aimed at describing uncommon or bizarre symptoms observed in patients suffering from dementia. Medline and Google scholar searches were conducted for relevant articles, chapters, and books published since 1967. Search terms used included uncommon presentation, behavioural and psychological symptoms, dementia, Alzheimer's disease, and fronto-temporal dementia. Publications found through this indexed search were reviewed for further relevant references. The uncommon symptoms are described as case-reports and there are no systematic investigations. Bizarre behaviours arising late in life should be thoroughly investigated as symptoms of dementia.