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    ABSTRACT: Delusional infestation or delusional parasitosis is a form of monodelusional disorder, a condition sometimes encountered in psychiatric or primary care practice. The outcome of this condition is good when compliance can be ensured. In the present study, a series of 50 consecutive cases of delusional infestation is reported. A majority of cases (94%) had insidious onset. The duration of symptoms in all but 3 cases was 6 months or more. Twenty-eight cases presented with a delusion of infestation by insects over the body and 20 cases with a delusion of insects crawling over the scalp. Two cases had associated diabetes mellitus, 3 cases had leprosy, 2 cases had dementia, 5 cases had depression, and 4 cases presented with trichotillomania. Among the second generation antipsychotics, risperidone was used in 12 cases, olanzapine in 9 cases, amisulpride in 7 cases, etc. Thirty-four cases (68%) showed complete remission while receiving pharmacotherapy, 13 cases showed partial improvement, and 3 cases did not respond to treatment. The study demonstrates the utility of second generation antipsychotics in the treatment of this disorder. Further studies are warranted to study the treatment and outcome of this important psychiatric disorder.
    04/2013; 6(2):124-7. DOI:10.1016/j.ajp.2012.09.008
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    ABSTRACT: The pathophysiology and appropriate pharmacological interventions for delusional infestation remain unknown. Here, we report a case of primary delusional infestation successfully treated with aripiprazole. We performed functional magnetic resonance imaging (fMRI) to investigate brain structures and functional modifications. Before antipsychotic treatment, pre- versus post-treatment fMRI images revealed a marked increase in brain activation in the supplementary motor area (SMA). Our results highlight the efficacy and safety of aripiprazole in the treatment of delusional infestation and the possible role of SMA dysfunction in delusional infestation. Indeed, our results suggest that psychiatric improvement of delusional infestation is associated with normalization of brain activity, particularly in the SMA.
    Neuropsychiatric Disease and Treatment 01/2015; 11:257-61. DOI:10.2147/NDT.S74786 · 2.00 Impact Factor
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    Australian and New Zealand Journal of Psychiatry 02/2014; 48(7). DOI:10.1177/0004867414525849 · 3.77 Impact Factor