Delusional Infestation: Perspectives from Scottish Dermatologists and a 10-year Case Series from a Single Centre

TY - JOUR

T1 - Delusional Infestation

T2 - Perspectives from Scottish Dermatologists and a 10-year Case Series from a Single Centre

AU - Wong, Yee Ling

AU - Affleck, Andrew

AU - Stewart, Alexander M.

N1 - no funding

PY - 2018

Y1 - 2018

N2 - Perceptions of the clinical management of delusional infestation (DI) were compared with clinical outcomes in this 10-year case series from a single centre in Dundee, UK. An online questionnaire (survey-monkey, a TM brand of online survey available for free for basic use) was sent to Scottish Dermatologists to gauge their opinions and confidence in the management of DI. Also, a retrospective review of medical case notes of patients seen by dermatologists in one institution was undertaken and clinical outcomes were reported by patients’ general practitioners. The survey showed that 61% of responding dermatologists encountered 1–5 cases of DI per year. 24% respondees were ‘confident’ in managing patients with DI, 54% were ‘somewhat confident’. Forty-seven patients (62% female, 70% single) were seen over the 10 years; 43% brought a self-collected specimen to clinic, 68% of patients had a psychiatric comorbidity, 23% of patients had primary DI and 11/47 (23%) were seen by a psychiatrist. Clinical outcomes as rated by patients’ GPs were reasonable or good in 2/3 patients. A poor outcome was seen in 12 patients and associated with chronic pain in 50% (p<0.01) and psychiatric comorbidity in 100% (p<0.01). We conclude that good outcomes can be achieved in some patients with DI without psychiatric input and without psychoactive treatment.

AB - Perceptions of the clinical management of delusional infestation (DI) were compared with clinical outcomes in this 10-year case series from a single centre in Dundee, UK. An online questionnaire (survey-monkey, a TM brand of online survey available for free for basic use) was sent to Scottish Dermatologists to gauge their opinions and confidence in the management of DI. Also, a retrospective review of medical case notes of patients seen by dermatologists in one institution was undertaken and clinical outcomes were reported by patients’ general practitioners. The survey showed that 61% of responding dermatologists encountered 1–5 cases of DI per year. 24% respondees were ‘confident’ in managing patients with DI, 54% were ‘somewhat confident’. Forty-seven patients (62% female, 70% single) were seen over the 10 years; 43% brought a self-collected specimen to clinic, 68% of patients had a psychiatric comorbidity, 23% of patients had primary DI and 11/47 (23%) were seen by a psychiatrist. Clinical outcomes as rated by patients’ GPs were reasonable or good in 2/3 patients. A poor outcome was seen in 12 patients and associated with chronic pain in 50% (p<0.01) and psychiatric comorbidity in 100% (p<0.01). We conclude that good outcomes can be achieved in some patients with DI without psychiatric input and without psychoactive treatment.

KW - Delusional

KW - Infestation

KW - Parasitosis

KW - Psychodermatology

U2 - 10.2340/00015555-2875

DO - 10.2340/00015555-2875

M3 - Article

C2 - 29270638

SN - 0001-5555

VL - 98

SP - 441

EP - 445

JO - Acta Dermato-Venereologica

JF - Acta Dermato-Venereologica

IS - 4

ER -