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[Delusional infestation, a therapeutic challenge].

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Delusional infestation, a challenging condition, can be effectively treated with antipsychotics. Focusing on symptom relief, rather than psychosis, improves patient acceptance and treatment success.

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Area of Science:

  • Psychiatry
  • Dermatology

Background:

  • Delusional infestation, also known as delusional parasitosis, presents significant therapeutic challenges.
  • Engaging patients with psychiatric treatment is crucial for managing this condition.

Observation:

  • Two male patients, aged 49 and 48, presented with dermatological symptoms attributed to primary and secondary delusional infestation.
  • Both patients exhibited anosognosia, a lack of insight into their condition.

Findings:

  • Successful treatment was achieved using antipsychotics through interdisciplinary collaboration between dermatology and psychiatry.
  • Emphasizing the antipruritic effects and reduced preoccupation with infestation, rather than antipsychotic properties, enhanced treatment acceptability.

Implications:

  • Antipsychotic therapy can be effective for delusional infestation, particularly when treatment rationale is tailored to patient perception.
  • Long-term follow-up is essential due to high recurrence rates after medication cessation and patients' tendency to not attribute recovery to antipsychotics.