Delusional Parasitosis: Clinical Features, Diagnosis and Treatment

Yıl 2010, Cilt: 2 Sayı: 3, 384 - 400, 01.09.2010

Gonca Karakuş

Öz

Delusional parasitosis is a delusional disorder in which the patient has the false and persistent belief that he is infested by some type of parasite or small living creatures. The disease has been called under different names such as "Ekbom syndrome" or psychogenic parasitosis in the last century. Delusional parasitosis is divided into primary, secondary functional and secondary organic groups. The female-to-male ratio in delusional parasitosis is approximately 2:1.Delusional parasitosis is associated in 5-15% of shared psychotic disorder and can run within a family (folie a familie). The diagnosis is one of exclusion, and other diseases that can also cause a sensation of itching should be considered, investigated, and treated if present. Lack of treatment might cause delusional symptoms to gain chronicity, and might further complicate treatment response. Antipsychotics, antidepressants, electroconvulsive therapy, and in the presence of dermatological lesions some topical dermatological agents and antihistaminics are used in the treatment of this disorder.

Anahtar Kelimeler

Delusional Parasitosis, Ekbom Syndrome, Delusional Disorder

Delüzyonel Parazitoz: Klinik Özellikleri, Tanı ve Tedavi

Öz

Delüzyonel parazitoz tıbbi bir kanıt olmamasına rağmen kişinin parazit ya da yaşayan küçük yaratıklar tarafından enfekte olduğu yanlış ve ısrarlı inancı ile seyreden sanrısal bir bozukluktur. Yüzyıldan uzun zamandır Ekbom hastalığı, psikojenik parasitoz gibi çeşitli isimlerle adlandırılmıştır. Delüzyonel parazitoz birincil veya ikincil olarak gelişebilir. Delüzyonel parazitoz patofizyolojisini açıklamada kognitif ve duyusal yaklaşımlardan bahsedilmektedir. Kadınlar erkeklerden daha fazla etkilenmektedir. DP genellikle tek kişide görülmesine rağmen bazen birden fazla kişide (folie a deux, folie a trois) hatta ailenin tüm bireylerinde (folie a famille) görülebilmektedir. Özellikle gerçek parazitozlarla ayırıcı tanısının yapılması gereklidir. Delüzyonel parazitoz olgularının çoğunda semptom bir kez yerleştikten sonra genellikle tedaviye yanıt düşüktür. Uzun sürelerle tedavisiz kalan hastalarda sanrısal sistem yerleşmekte ve kronikleşmektedir. Tedavisinde antipsikotikler, antidepresanlar, elektrokonvulsif tedavi; cilt lezyonları varsa topikal dermatolojik ajanlar ve antihistaminikler kullanılmaktadır.

Anahtar Kelimeler

Delüzyonel Parazitoz, Ekbom Sendromu, Sanrısal Bozukluk

Kaynakça

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