Indian Journal of Dermatology
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Year : 1991  |  Volume : 36  |  Issue : 3  |  Page : 64-75

Delusion of parasltosis : a combined study by dermatologist, psychiatrist and physician

Unit of psychiatry, North Bengal Medical College, Distt Darjeeling

Correspondence Address:
S Biswas
Unit of psychiatry, North Bengal Medical College, Distt Darjeeling

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Source of Support: None, Conflict of Interest: None

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ABSTRACT: Patients coming with presenting symptom of false and intractable idea of infestation of skin by tiny insects were pooled from dermatology and psychiatry clinics of a teaching hospital for eight (8 yrs) years. 26 such patients identified consisting of 0.05 percent of total patients seen. Dermatologists could not find any organic basis for the complaint but found various types of self induced skin lesions in these patients. Psychiatric examination revealed 7 different types of psychiatric illness in these 26 patients. In one group of 12 coming mainly from dermatology clinic, the delusion seemed to be the central problem. This group showed many similarities among themselves in clinical history, response to drugs, long term foflow up etc. They were grouped under heading of 'delusional (paranoid) disorder, somatic type'(using current American Psychiatric Association criteria DSM-III-R 1987). Rest of the cases coming from dermatology clinic were elderly depressives. Careful psychiatric history only could differentiate them from the delusional disorder group. Patients coming directly to Psychiatry clinic were of more varied aetiology. Patients responded to treatment given according to psychiatric diagnosis. Delusional disorder group did not respond to phenothiazine but responded partly to tricyclic anti depressants and responded well to pimozide.

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