Portal de Periódicos da CAPES

How to approach delusional infestation

2015; Volume: 350; Issue: apr01 3 Linguagem: Inglês

10.1136/bmj.h1328

1756-1833

Peter Lepping, Markus Huber, Roland W. Freudenmann,

Mental Health and Psychiatry

#### The bottom line Delusional infestation (previously also known as delusional parasitosis or Ekbom’s syndrome) is a rare disorder, but it commonly poses disproportionate practical problems to healthcare systems.1 It is characterised by a patient’s fixed belief that his or her skin, body, or immediate environment is infested by small, living (or less often inanimate) pathogens despite the lack of any medical evidence for this.1 Delusional infestation is neither a single disease nor a single diagnostic entity. The classic form, primary delusional infestation, develops without any known cause or underling illness and meets criteria for a persistent delusional disorder (ICD-10 (international classification of diseases, 10th revision)) or delusional disorder somatic type (DSM-5 ( Diagnostic and Statistical Manual of Mental Disorders , fifth edition)). Approximately 60% of patients, however, have secondary forms of delusional infestation2 that occur in the context of substance misuse (such as cocaine, amphetamines, cannabis), dopaminergic medications, antibiotics, or during physical or psychiatric illnesses (such as delirium, dementia, depression, schizophrenia, stroke, and other medical conditions that affect the brain or cause pruritus).1 2 The neurobiology of delusional infestation is not fully understood. Studies point to dysfunction or structural brain damage in the frontal cortex, …