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Reframing delusional infestation: perspectives on unresolved puzzles.

Jianbo Lai1,2,3, Zhe Xu4,5, Yi Xu1,2,3

  • 1Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China, dorhushaohua@zju.edu.cn.

Psychology Research and Behavior Management
|October 16, 2018
PubMed
Summary

Delusional infestation (DI) and Morgellons disease (MD) are poorly understood conditions. This review clarifies their complex relationship, diagnostic challenges, and proposes a multifactorial approach for better understanding.

Keywords:
Morgellons diseasebehaviordelusional infestationinsightneurotransmitter

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Area of Science:

  • Psychiatry
  • Dermatology
  • Neurology

Background:

  • Delusional infestation (DI) is a psychocutaneous condition characterized by false beliefs of infestation, somatosensory disturbances, and behavioral changes.
  • Morgellons disease (MD) presents with cutaneous filaments and is debated due to potential links with spirochetal infections.
  • The etiology of DI and MD remains unclear, hindering effective diagnosis and treatment.

Purpose of the Study:

  • To review and clarify the complex relationship between real/sham infestations and DI/MD.
  • To discuss behavioral alterations, neuroimaging, neurotransmitter systems, and impaired insight in DI/MD patients.
  • To propose a multifactorial diagnostic approach for DI/MD.

Main Methods:

  • Literature review and critical analysis of existing research on DI and MD.
  • Discussion of key diagnostic challenges and etiological factors.
  • Synthesis of information to propose a comprehensive diagnostic framework.

Main Results:

  • DI and MD share overlapping symptoms and diagnostic complexities.
  • Behavioral changes, neurobiological abnormalities, and impaired insight are significant aspects of these conditions.
  • A multifactorial approach is suggested for improved diagnosis.

Conclusions:

  • Further research into the neurobiological underpinnings of DI/MD is essential.
  • Clarifying the relationship between infestation beliefs and cutaneous symptoms is crucial.
  • A comprehensive diagnostic strategy is needed to address the complexities of DI/MD.