Erotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the ‘passionate psychosis', as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders.

To describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders.

Literature review and a case report

We report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed.

After reviewing the literature, we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially major depression and bipolar affective disorder, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder : from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link.

In clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.