There are several unique psychiatric disorders that are likely to present to a dermatologist because of their accompanying skin complaints. Delusions of parasitosis (DP) is a fixed, false belief of parasitic infestation that may lead patients to compulsively self-mutilate while attempting to remove the non-existent parasites. Morgellons disease is a controversial condition characterized by a fixed belief that fibers that are imbedded or extruding from the skin; this condition is likely in the spectrum of DP. Body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance that causes significant distress and is associated with time consuming rituals, isolation, depression, and increased risk of suicide. Olfactory reference syndrome (ORS) is a preoccupation with body odor leading to the stigmata of shame, embarrassment, and social isolation. This brief review examines each of these conditions and their management because any one of them may present to a dermatologist.
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Delusional Themes are More Varied Than Previously Assumed: A Comprehensive Systematic Review and Meta-Analysis.
Schizophr Bull
January 2025
Clinical, Educational and Health Psychology, University College London, London, WC1E 6BT, UK.
Background And Hypothesis: Delusions are classified into themes but the range of themes reported in the literature has never been examined and the extent to which they differ in prevalence, or relate to clinical characteristics or cultural variation, remains poorly understood.
Study Design: We identified studies reporting delusional theme prevalence in adults with psychosis and completed two multivariate, multilevel, random-effects meta-analyses: one including data from structured assessment scales only and another also including data from ad hoc and clinical assessments to include themes from a wider range of countries and contexts. Sensitivity and meta-regression analyses examined the association with clinical and methodological variables.
Longitudinal evolution of the transdiagnostic prodrome to severe mental disorders: a dynamic temporal network analysis informed by natural language processing and electronic health records.
Mol Psychiatry
January 2025
Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Modelling the prodrome to severe mental disorders (SMD), including unipolar mood disorders (UMD), bipolar mood disorders (BMD) and psychotic disorders (PSY), should consider both the evolution and interactions of symptoms and substance use (prodromal features) over time. Temporal network analysis can detect causal dependence between and within prodromal features by representing prodromal features as nodes, with their connections (edges) indicating the likelihood of one feature preceding the other. In SMD, node centrality could reveal insights into important prodromal features and potential intervention targets.
View Article and Find Full Text PDFPrevalence and Characteristics of Delusional Infestation in Individuals With Opiate Use Disorders Within One Health System: A Retrospective Cross-Sectional Study.
Cureus
December 2024
Department of Medicine, Tower Health Medical Group, Reading, USA.
Objective: The recent development of xylazine adulteration of the illicit opiate supply has been associated with necrotic extremity wounds of unclear pathogenesis. This study sought to understand the prevalence and characteristics of delusional infestation (DI) among patients with opiate use disorders who also carried a diagnosis of cellulitis.
Methods: A retrospective cross-sectional study was performed in one health system to identify patients with opiate use disorder and cellulitis over the past three years who also described symptoms of DI.
Challenges in the management of visual and tactile hallucinations in elderly people.
World J Psychiatry
January 2025
Division of Geriatric Psychiatry, Department of Psychiatry, Changhua Christian Hospital, Changhua 500, Taiwan.
This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients. The discussion addresses differential diagnoses and potential underlying mechanisms, as well as the psychopathology associated with tactile hallucinations, and emphasizes the necessity for investigation into the possibility of coexisting delusional infestation (parasitosis). These symptoms frequently manifest in patients with primary psychotic disorders, organic mental disorders, and substance use disorders.
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A young lady was brought to the hospital by the police after they found her wandering in the streets far away from her home behaving oddly. At admission, she was confused and had various delusional thoughts accompanied by visual and auditory hallucinations. After she was identified and her old medical notes were retrieved, it was found that she had a diagnosis of systemic lupus erythematosus (SLE) previously for which she declined any treatment.
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