Characteristics of Delusional Parasitosis and Treatment

Delusional parasitosis is a detachment from reality in which people are convinced their body is infested by parasites. Learn more about this rare condition here.
Characteristics of Delusional Parasitosis and Treatment

Last update: 25 September, 2021

Delusional parasitosis is a type of psychosis in which patients believe their body is full of parasites. Similarly, they often think their homes are infested with mites or other pests. Their accounts of such delusions are quite credible.

It may be hard to believe, but the sensations these people experience are quite real. In fact, some of them even tear their skin during such intense and prevalent episodes. They just need to get the parasites out of their organism and will go as far as to hurt themselves to do so.

Likewise, there’s also an urge to prove that the parasites are real and they frequently seek a medical examination. In addition, they take samples of hair, nails, and even skin scabs to labs to have them scrutinized.

Continue reading to find out more about it.

The causes of delusional parasitosis

This disorder has various causes. In most cases, people present comorbidity with other conditions, such as anxiety disorders. It also occurs in hypochondriacs or people with post-traumatic stress disorder (PTSD).

This often happens after people learn about diseases caused by parasites and this knowledge makes them worry, often irrationally.

An itchy person.
Delusional parasitosis is often due to other disorders such as anxiety and post-traumatic stress disorder.

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Types of delusional parasitosis

There are different types of delusional parasitosis. There’s a detachment from reality in all of them but there are particularities worth distinguishing. Below we’ll review a list of the most frequent ones. Let’s take a look at them!

1. Anxiety

As we mentioned above, anxiety is one of the main causes. Patients with delusional parasitosis experience catastrophic thoughts that are typical of anxiety. In these cases, the false sensations are due to disproportionate worry.

2. Substance abuse

The consumption of certain substances is another cause. For instance, cocaine has a stimulant effect on the central nervous system. Furthermore, it produces hallucinations and intense physical sensations. Other studies indicate that the consumption of intravenous methylphenidate causes Ekbom’s syndrome (delusional parasitosis).

3. Withdrawal syndrome

People undergoing alcohol withdrawal syndrome experience the kind of body tingling usually present in delusional parasitosis. It’s common for heavy drinkers who quit to show these signs for a given period.

Most hallucinatory delusions have common indicators. The related symptoms of Ekbom’s syndrome are tactile and visual hallucinations.

People see and feel parasites crawling all over and invading their bodies. These imaginary sensations usually come with highly detailed descriptions.

The fixation on being sick due to insects invading the body is also a symptom related to sickness anxiety disorder.

Possible complications

Self-flagellation is one of the most worrisome complications as people often cut their bodies in an attempt to remove the invading parasites. Similarly, self-medication is also a frequent problem.

People apply various lotions to their skin to kill the alleged invaders. However, it’s more serious when they ingest substances like chlorine or do enemas.

Diagnosing delusional parasitosis

Delusional parasitosis isn’t easy to diagnose because pruritus (an itching sensation following by the need to scratch) is a symptom of other existing skin conditions. In this regard, one must determine whether the itching sensation is real or imaginary.

The diagnostic procedure involves a physical examination and laboratory tests. In principle, the aim is to rule out a real infestation. It’s also important to review the patient’s personal and family history. A history of drug use and mental illness, for example.

A doctor must refer a patient who insists on being itchy but whose results are negative to a mental health specialist. A psychologist or psychiatrist should be able to make an accurate diagnosis.

Treatment of delusional parasitosis

The most effective treatment for this condition is psychological therapy. However, the approach must include a dermatologist. First of all, they just establish a good rapport with the patient to gain their trust. Then, they must try to prove that there’s no physical reason for the itch.

The psychologist must use logic and make the patient reach a personal conclusion regarding his situation using a maieutic process. Also, the specialist must interrogate the patient during the sessions and convince them that it isn’t possible to be infested with parasites when there’s no medical evidence.

The hallucinations become pseudohallucinations after successful therapy. In other words, people become aware of their situation and recognize them as a delusion even if they continue to experience false sensations.

It’ll be necessary to implement pharmacological treatment in some cases. Also, a psychiatrist should prescribe neuroleptics when the origin of the delusions is organic. The psychological therapy must continue even when this is the case.

A person undergoing therapy.
Psychological therapy plays a major role in the treatment of delusional parasitosis.

Perspective

This condition depicts real sensations that affect a person in every area of their life. However, one cannot say it’s a physical disease because most of these people are healthy. Delusional parasitosis is basically a rare form of psychosis.

What to do if a person with delusional parasitosis refuses psychological help

People often refuse to acknowledge the need to consult a psychologist. The most likely reason for this refusal is they don’t feel people take them seriously. This is why other specialists must emphasize the importance of psychological care.

Physicians must help the patient understand that a psychological consultation is just another part of the diagnostic process. Patients will be more likely to agree to consult one when they don’t feel judged.

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  • Cruzado, Lizardo, and Renzo Paima Ríos. “Parasitosis Delirante: Sinergia Entre Psiquiatría y Otras Especialidades.” Acta méd. peru 29.1 (2012): 35–37. Print.
  • Rodríguez-Alonso, Beatriz et al. “Delusional Parasitosis. A Multicenter Retrospective Study in Spanish Infectious Disease Services.” Enfermedades infecciosas y microbiologia clinica (English ed.) 39.5 (2021): 223–228. Enfermedades infecciosas y microbiologia clinica (English ed.). Web.
  • Hinkle NC. Ekbom syndrome: a delusional condition of “bugs in the skin”. Curr Psychiatry Rep. 2011 Jun;13(3):178-86. doi: 10.1007/s11920-011-0188-0. PMID: 21344286.
  • “Presensación de Un Caso de Síndrome de Ekbom.” Correo Científico Médico de Holguín 16.2 (2012): n. pag. Print.
  • Hinkle NC. Ekbom syndrome: the challenge of “invisible bug” infestations. Annu Rev Entomol. 2010;55:77-94. doi: 10.1146/annurev.ento.54.110807.090514. PMID: 19961324.
  • et al. “A Propósito de Un Caso: Consumo de Estimulantes y Delirio de Parasitosis.” Sociedad Espanola de Patologia Dual (SEPD), 2020. Web.