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Delusional Parasitosis in the Elderly: A Review and Report of Six Cases From Northern Finland

Published online by Cambridge University Press:  10 January 2005

Pirkko Räsänen
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Kari Erkonen
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Ulrica Isaksson
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Pirjo Koho
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Risto Varis
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Markku Timonen
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Esa Leinonen
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Matti Isohanni
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
Antti Alanko
Affiliation:
Department of Psychiatry, University of Oulu, Oulu, Finland.
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Abstract

A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in “matchboxes” to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.

Type
An Aspect of Psychosis
Copyright
© 1997 International Psychogeriatric Association

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