Original Article

Delusional Parasitosis: A seven-year retrospective analysis of 25 cases in tertiary level hospital


Author Details

1. Head & Associate Professor, Dept. of Psychiatry, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.

2. Head & Associate Professor, Dept. of Dermatology and Venereology, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.

3. Associate Professor, Dept. of Dermatology and Venereology, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.

4. Assistant Professor, Dept. of Dermatology and Venereology, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.

5. Associate Professor, Dept. of Medicine, Holy Family Red Crescent Medical College, Dhaka, Bangladesh.

6. Consultant, Matador Skin Center, Dhaka. Bangladesh.


Abstract

Background: Delusional parasitosis (DP) is a delusional state with a fixed false belief of having an infestation of insects, mites, lice, worms or other organisms. It is a rare psycho-cutaneous disease entity mostly misdiagnosed initially by non-psychiatrist medical practitioners making early diagnosis and management challenging. Objective: To analyse socio-demographic and clinical profiles of delusional parasitosis. Methods: This retrospective study was carried out in the dept. of psychiatry, holy family red crescent medical college, Dhaka, Bangladesh over 7 years (January 2017- December 2022). From 12940 registered cases of different psychiatric illnesses diagnosed by psychiatrists according to DSM-5, 25 cases of DP were diagnosed sorted out and enrolled for analysis. Data of sociodemographic profile and clinical information especially psychiatric history and diagnosis and other comorbidities especially dermatological complains and manifestations were reviewed by psychiatrist and dermatologist. Result: The frequency of DP among psychiatric illnesses is 0.2%. The mean age of the patients of DP was 54.56±6.02 years ranging from 45 to 69, female to male ratio was 1:2.6. The Majority (76%) of the DP patients were of secondary type with comorbid medical and psychiatric illness including major psychiatric disorders such as schizophrenia, substance use disorder (cannabis, amphetamine and alcohol), obsessive-compulsive disorder, major depressive disorder and trichotillomania. The mean duration of delusional symptoms was 9.88 ±2.64 months. Among 25 patients of DP, 17 were initially treated by non-psychiatrists (mostly dermatologists). Conclusion: For early diagnosis and management of delusional parasitosis exclusion of suspected dermatological conditions and timely referral to a psychiatrist is crucial to minimize the burden of psychiatric manifestation and reduce the cutaneous discomfort and disfigurement.

Keywords: Delusional parasitosis, Delusional infestation, Dermatological delusion, Ekbom syndrome

Keywords: Delusional Parasitosis, Delusional Infestation, Dermatological Delusion, Ekbom Syndrome

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