Delusional parasitosis

Delusional parasitosis (DP) is a mental disorder in which individuals have a persistent belief that they are infested with living or nonliving pathogens such as parasites, insects, or bugs, when no such infestation is present. They usually report tactile hallucinations known as formication, a sensation resembling insects crawling on or under the skin. Morgellons is considered to be a subtype of this condition, in which individuals have sores that they believe contain harmful fibers. Delusional parasitosis is classified as a delusional disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM5). The cause is unknown, but is thought to be related to excess dopamine in the brain. Delusional parasitosis is diagnosed when the delusion is the only symptom of psychosis and the delusion—that cannot be better explained by another condition—has lasted a month or longer. Few individuals with the condition willingly accept treatment, because they do not recognize the illness as a delusion. Antipsychotic medications offer a potential cure, while cognitive behavioral therapy and antidepressants can be used to help alleviate symptoms. The condition is rare, and is observed twice as often in women as men. The average age of people with the disorder is 57. An alternative name, Ekbom's syndrome, honors the neurologist Karl-Axel Ekbom, who published seminal accounts of the disease in 1937 and 1938. Delusional infestation is classified as a delusional disorder of the somatic subtype in the Diagnostic and Statistical Manual of Mental Disorders (DSM5). The name delusional parasitosis has been the most common name since 2015, but the condition has also been called delusional infestation, delusory parasitosis, delusional ectoparasitosis, psychogenic parasitosis, Ekbom syndrome, dermatophobia, parasitophobia, formication and "cocaine bugs". Morgellons is a form of delusional parasitosis in which people have painful skin sensations that they believe contain fibers of various kinds; its presentation is very similar to other delusional infestations, but people with this self-diagnosed condition also believe that strings or fibers are present in their skin lesions.

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Delusional disorder is a mental illness in which a person has delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis. Delusions can be bizarre or non-bizarre in content; non-bizarre delusions are fixed false beliefs that involve situations that could occur in real life, such as being harmed or poisoned.

Formication is the sensation resembling that of small insects crawling on (or under) the skin when nothing is actually there. It is one specific form of a set of sensations known as paresthesias, which also include the more common prickling, tingling sensation known as pins and needles. Formication is a well-documented symptom which has numerous possible causes. The word is derived from formica, the Latin word for ant. Formication may sometimes be experienced as feelings of itchiness, tingling, pins and needles, burning, or even pain.

Stimulant psychosis is a mental disorder characterized by psychotic symptoms (such as hallucinations, paranoid ideation, delusions, disorganized thinking, grossly disorganized behaviour). It involves and typically occurs following an overdose or several day 'binge' on psychostimulants; however, one study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy.

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