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Delusional Parasitosis Case Study Essay

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Background: Delusional Parasitosis (DP) is a rare psychiatric disorder, in which patients have fixed false belief that small pathogens infested their body. The initial psychiatric diagnosis is often based on the exclusion of organic causes. By the time patients are referred for psychiatric evaluation, they already have a significant functional decline; in severe cases, patients are impaired globally and lack capacity for self-care. While treatment of DP has been the focus, psychiatric warning signs in the prodromal stage receive little attention. Here we present a case of DP comorbid with alcohol abuse. Case Presentation: the patient is a 61-year-old woman, single, childless, retired physician, lives alone in NYC with no formal psychiatric history, who presented to ED with c/o leg swelling and skin infection with flies and fly larva. She provided a huge photo collection of her toilet with stool and nasal mucous tissue and claimed that they were infested. She firmly believed that she suffered from a condition called myiasis, although laboratory workups from different medical providers showed no evidence of infestation. She received a psychiatric evaluation at the ED, which revealed that she had a history of episodically alcohol and cannabis abuse for many years and increased a significant amount of alcohol intake for the past 6 months. She explained that the renovations were started in the apartment above hers 6 months ago and many small flies came into her apartment and began to lay larvae in her body. This led to her abusing laxatives to cleanse her GI tract causing her …show more content…

Identification of prodromal symptoms (e.g., substance abuse, anxiety, and mood disturbances) before PD fully developing has an important clinical implication. Treatment of comorbid psychiatric conditions is equally critical as treatment of

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