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Morgellons Disease, or Antipsychotic-Responsive Delusional Parasitosis, in an HIV Patient: Beliefs in The Age of the Internet

2010; Elsevier BV; Volume: 51; Issue: 6 Linguagem: Inglês

10.1016/s0033-3182(10)70736-2

1545-7206

Oliver Freudenreich, Nicholas Kontos, Constantin Tranulis, Corinne Cather,

Mental Health and Psychiatry

“Which was worse, the real condition or the self-created one; and did it matter?” — Don DeLillo: “White Noise” Viking Press © 1985 Morgellons disease (also referred to as Morgellons syndrome or Morgellons) has been publicized through the Internet as an unexplained syndrome presenting with cutaneous dysesthesias associated with foreign material like fibers or parasites. A lay person, Mary Leitao, was instrumental in naming the disease after her 2-year-old son developed sores and began to complain about bugs. She established a nonprofit research organization, the Morgellons Research Foundation (MRF) and lobbied for widespread recognition. Under public and political pressure (e.g., letters to the Centers for Disease Control [CDC] from Senators Schumer and Clinton) the CDC has launched an epidemiologic investigation into this unexplained dermopathy. Table 1 shows how this condition rose to relative prominence in less than a decade. The phenomenological overlap, however, with delusional parasitosis has not escaped attention. A brief look at a proposed case definition (Table 2) shows the phenomenological overlap with regard to a core feature of delusional parasitosis (the sense of something moving in or under one’s skin), as well as a host of nonspecific symptoms. Is the creation of this new syndrome necessary or useful? Vila-Rodriguez and MacEwan have raised awareness about the facilitative role of the Internet in the spread of bizarre beliefs and shared delusional ideation, which raises the question of whether the propagation of new syndromes by laypersons is unavoidable in the age of the Internet. Herein, the authors describe the case of a patient with human immunodeficiency virus (HIV) disease and classic delusions of parasitosis, who diagnosed himself with Morgellons disease, yet responded to antipsychotic medication. The authors propose an infectious-disease, vectorbased model to explain the emergence and rapid rise of Morgellons and suggest principles of management for cases of antipsychotic-responsive cases of Morgellons.