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Folie en Famille: A Case Report of Shared Delusory Parasitosis

Published online by Cambridge University Press:  01 September 2022

A. Al Siaghy*
Affiliation:
Hamad Medical Corporation, Sidra Medicine, Psychiatry, Doha, Qatar
Y. Zoghbi
Affiliation:
Hamad Medical Corporation, Psychiatry, Doha, Qatar
M. Azeem
Affiliation:
Sidra Medicine, Child And Adolescent Psychiatry, Doha, Qatar
*
*Corresponding author.

Abstract

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Introduction

Delusional parasitosis, first documented in 1946, is a rare psychiatric illness described as both a stand-alone diagnosis, as well as a secondary condition to an underlying psychiatric or medical pathology, or substance use. Interestingly, the fixed false belief of being infested has also been identified in partners of individuals with the disease, and in some cases the delusion permeated families and was thus given the name “folie en famille”.

Objectives

To describe the first reported case of delusional disorder, somatic type, with similar delusional symptoms in the patient’s husband, in the State of Qatar.

Methods

Patient and her husband were interviewed. Her file was reviewed for past history and medications.

Results

34-year-old female with no past psychiatric history, 5 months post-partum, reported fixed beliefs of insect infestation in her baby’s skin, hers, and her husband’s, of 2 months duration. She reports a pruritic rash, and perceives proliferating insects in different life stages. The family relocated 5 times in 2 months. They bathe in vinegar several times a day to exterminate the insects. Husband mirrors her account of infestation with milder symptoms. Repeated medical investigations were insignificant. OCD, mood disorder, and other psychotic illnesses were ruled out.

Conclusions

Delusional parasitosis presents a unique therapeutic challenge to psychiatrists. It is necessary to build rapport with patients, rule out comorbidities, and conduct randomized controlled trials to evaluate the effectiveness of psychotropic drugs in its treatment. In cases of shared delusions, identifying the primary patient is crucial for treatment of all the individuals that share the delusion.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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