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Peter Lepping - One of the best experts on this subject based on the ideXlab platform.
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Secondary Delusional Parasitosis treated with paliperidone.
Clinical and experimental dermatology, 2008Co-Authors: Roland W. Freudenmann, Peter Lepping, P. Kühnlein, C. Schönfeldt-lecuonaAbstract:Second-generation antipsychotics (SGA) are increasingly used in primary and secondary Delusional Parasitosis (DP) because of their better overall tolerability compared with first-generation antipsychotics (FGA) such as pimozide. Controlled clinical trials with antipsychotics in DP are lacking, owing to difficulties in obtaining informed consent and in securing adherence to a study protocol by patients with DP. We present the case of an 88-year-old man with a 12-year history of DP secondary to leucoencephalopathy. After 9 days of an age-adapted dose of paliperidone, the patient no longer experienced the presence of vermin on his skin and stopped showering at night to get rid off of them. Paliperidone was well tolerated. At follow-up after 2 weeks, the DP was still remitted. Paliperidone appears to expand the therapeutic arsenal in treating DP with modern SGAs; however, this finding needs to be replicated.
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Delusional Parasitosis: a new pathway for diagnosis and treatment.
Clinical and experimental dermatology, 2008Co-Authors: Peter Lepping, Roland W. FreudenmannAbstract:Delusional Parasitosis is an uncommon disorder that presents particular challenges to the dermatologist. Patients often resist psychiatric referral. Evidence of efficacy of treatment options is generally weak, but some studies exist. By identifying whether the disorder is primary or secondary to another illness, by attempting to involve the liaison psychiatry team if possible and by treating the patient with a modern antipsychotic, remission is achievable. A pathway for diagnostics and therapy is presented. Treatments of choice are 'atypical' or second-generation antipsychotics such as amisulpride, risperidone or olanzapine in age-appropriate doses. Pimozide is no longer the treatment of choice, owing to a higher risk of adverse drug reactions and lower concordance. In some cases, depot antipsychotics can be considered. For diagnostics and treatment, close collaboration of dermatologists and psychiatrists is recommended.
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Primary Delusional Parasitosis treated with olanzapine.
International psychogeriatrics, 2007Co-Authors: Roland W. Freudenmann, C. Schönfeldt-lecuona, Peter LeppingAbstract:Delusional Parasitosis (DP) is a rare psychiatric disorder, predominantly observed in middle aged and elderly patients. It can manifest itself as an isolated Delusional disorder (primary DP), as a symptom of another psychiatric disorder or as an organic or toxic psychosis. The typical antipsychotic pimozide was traditionally considered to be the gold standard for treating DP. Compared with pimozide, atypical antipsychotics have many advantages in terms of tolerability, but their effectiveness has only been shown in a few case reports, which do not differentiate between primary and other forms of DP. We present the case of a 77-year-old woman with primary DP who responded markedly to the atypical antipsychotic olanzapine (2.5 mg daily). She was treated in a psychiatric outpatient department with a follow-up period of 3.5 years. This is the first report of a successful olanzapine mono-therapy in primary DP in such a setting and the longest follow-up period ever reported. The need for maintenance treatment was demonstrated. Olanzapine in age-adapted doses should be considered as an alternative treatment. This paper also provides a review of all published cases in which primary DP was treated with atypical antipsychotics.
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Antipsychotic treatment of primary Delusional Parasitosis: systematic review.
The British journal of psychiatry : the journal of mental science, 2007Co-Authors: Peter Lepping, Ian Russell, Roland W. FreudenmannAbstract:Background Little is known about the treatment of Delusional Parasitosis with typical and atypical antipsychotics. Aims To evaluate the effectiveness of typical and atypical antipsychotics in primary Delusional Parasitosis (Delusional disorder, somatic type). Method A systematic review was conducted. Results No randomised trials were found and hence we collected the best evidence from 16 other trials and case reports, separating primary from other forms of Delusional Parasitosis. Studies using typical antipsychotics showed partial or full remission in between 60 and 100% of patients. Analysis of selected patients with primary Delusional Parasitosis showed that typical and atypical antipsychotics were effective in the majority, but that remission rates did not differ significantly between typical and atypical antipsychotics. Conclusions In the absence of controlled trials there is limited evidence that antipsychotics are effective in primary Delusional Parasitosis. Rigorous studies are needed to evaluate their effectiveness and to compare typical and atypical antipsychotics directly.
Roland W. Freudenmann - One of the best experts on this subject based on the ideXlab platform.
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Secondary Delusional Parasitosis treated with paliperidone.
Clinical and experimental dermatology, 2008Co-Authors: Roland W. Freudenmann, Peter Lepping, P. Kühnlein, C. Schönfeldt-lecuonaAbstract:Second-generation antipsychotics (SGA) are increasingly used in primary and secondary Delusional Parasitosis (DP) because of their better overall tolerability compared with first-generation antipsychotics (FGA) such as pimozide. Controlled clinical trials with antipsychotics in DP are lacking, owing to difficulties in obtaining informed consent and in securing adherence to a study protocol by patients with DP. We present the case of an 88-year-old man with a 12-year history of DP secondary to leucoencephalopathy. After 9 days of an age-adapted dose of paliperidone, the patient no longer experienced the presence of vermin on his skin and stopped showering at night to get rid off of them. Paliperidone was well tolerated. At follow-up after 2 weeks, the DP was still remitted. Paliperidone appears to expand the therapeutic arsenal in treating DP with modern SGAs; however, this finding needs to be replicated.
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Delusional Parasitosis: a new pathway for diagnosis and treatment.
Clinical and experimental dermatology, 2008Co-Authors: Peter Lepping, Roland W. FreudenmannAbstract:Delusional Parasitosis is an uncommon disorder that presents particular challenges to the dermatologist. Patients often resist psychiatric referral. Evidence of efficacy of treatment options is generally weak, but some studies exist. By identifying whether the disorder is primary or secondary to another illness, by attempting to involve the liaison psychiatry team if possible and by treating the patient with a modern antipsychotic, remission is achievable. A pathway for diagnostics and therapy is presented. Treatments of choice are 'atypical' or second-generation antipsychotics such as amisulpride, risperidone or olanzapine in age-appropriate doses. Pimozide is no longer the treatment of choice, owing to a higher risk of adverse drug reactions and lower concordance. In some cases, depot antipsychotics can be considered. For diagnostics and treatment, close collaboration of dermatologists and psychiatrists is recommended.
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Primary Delusional Parasitosis treated with olanzapine.
International psychogeriatrics, 2007Co-Authors: Roland W. Freudenmann, C. Schönfeldt-lecuona, Peter LeppingAbstract:Delusional Parasitosis (DP) is a rare psychiatric disorder, predominantly observed in middle aged and elderly patients. It can manifest itself as an isolated Delusional disorder (primary DP), as a symptom of another psychiatric disorder or as an organic or toxic psychosis. The typical antipsychotic pimozide was traditionally considered to be the gold standard for treating DP. Compared with pimozide, atypical antipsychotics have many advantages in terms of tolerability, but their effectiveness has only been shown in a few case reports, which do not differentiate between primary and other forms of DP. We present the case of a 77-year-old woman with primary DP who responded markedly to the atypical antipsychotic olanzapine (2.5 mg daily). She was treated in a psychiatric outpatient department with a follow-up period of 3.5 years. This is the first report of a successful olanzapine mono-therapy in primary DP in such a setting and the longest follow-up period ever reported. The need for maintenance treatment was demonstrated. Olanzapine in age-adapted doses should be considered as an alternative treatment. This paper also provides a review of all published cases in which primary DP was treated with atypical antipsychotics.
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Antipsychotic treatment of primary Delusional Parasitosis: systematic review.
The British journal of psychiatry : the journal of mental science, 2007Co-Authors: Peter Lepping, Ian Russell, Roland W. FreudenmannAbstract:Background Little is known about the treatment of Delusional Parasitosis with typical and atypical antipsychotics. Aims To evaluate the effectiveness of typical and atypical antipsychotics in primary Delusional Parasitosis (Delusional disorder, somatic type). Method A systematic review was conducted. Results No randomised trials were found and hence we collected the best evidence from 16 other trials and case reports, separating primary from other forms of Delusional Parasitosis. Studies using typical antipsychotics showed partial or full remission in between 60 and 100% of patients. Analysis of selected patients with primary Delusional Parasitosis showed that typical and atypical antipsychotics were effective in the majority, but that remission rates did not differ significantly between typical and atypical antipsychotics. Conclusions In the absence of controlled trials there is limited evidence that antipsychotics are effective in primary Delusional Parasitosis. Rigorous studies are needed to evaluate their effectiveness and to compare typical and atypical antipsychotics directly.
Kenneth R. Kaufman - One of the best experts on this subject based on the ideXlab platform.
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Delusional Parasitosis on the psychiatric consultation service – a longitudinal perspective: case study
British Journal of Psychiatry Open, 2017Co-Authors: Adam Trenton, Neha H. Pansare, Anthony Tobia, Viwek Bisen, Kenneth R. KaufmanAbstract:Background Delusional Parasitosis is infrequently seen in hospital-based consultation–liaison psychiatry. Aims Although there are many publications on Delusional Parasitosis, this report reviews a unique case that was diagnosed during a hospital admission and treated over the next 36 months. Method Case report and literature review. Results This case report describes a 65-year-old man who was diagnosed with Delusional Parasitosis during a hospital admission for congestive heart failure and acute kidney injury. A longitudinal description of the patient's condition during the hospital stay and in the 36 months following discharge, during which time he was treated by a consultation psychiatrist, is provided. Conclusions In discussing the treatment of a challenging presentation, this case demonstrates the opportunity for consultation psychiatrists to initiate care in patients who might not otherwise seek psychiatric services. Patients with somatic delusions represent one group of patients who are unlikely to independently seek psychiatric treatment.
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Delusional Parasitosis on the psychiatric consultation service a longitudinal perspective case study
British Journal of Psychiatry Open, 2017Co-Authors: Adam Trenton, Neha H. Pansare, Anthony Tobia, Viwek Bisen, Kenneth R. KaufmanAbstract:Background Delusional Parasitosis is infrequently seen in hospital-based consultation–liaison psychiatry. Aims Although there are many publications on Delusional Parasitosis, this report reviews a unique case that was diagnosed during a hospital admission and treated over the next 36 months. Method Case report and literature review. Results This case report describes a 65-year-old man who was diagnosed with Delusional Parasitosis during a hospital admission for congestive heart failure and acute kidney injury. A longitudinal description of the patient's condition during the hospital stay and in the 36 months following discharge, during which time he was treated by a consultation psychiatrist, is provided. Conclusions In discussing the treatment of a challenging presentation, this case demonstrates the opportunity for consultation psychiatrists to initiate care in patients who might not otherwise seek psychiatric services. Patients with somatic delusions represent one group of patients who are unlikely to independently seek psychiatric treatment.
Jessica E. Bury - One of the best experts on this subject based on the ideXlab platform.
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iatrogenic Delusional Parasitosis a case of physician patient folie a deux
General Hospital Psychiatry, 2010Co-Authors: Jessica E. Bury, Michael J BostwickAbstract:This report presents a patient incorrectly diagnosed first with parasitic infestation and then with primary Delusional Parasitosis (DP). Neither diagnosis was correct. As she traveled from doctor to doctor, however, the primary DP label gained credibility via repetition, with her ongoing symptoms seen as proof of its truth.
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Iatrogenic Delusional Parasitosis: a case of physician–patient folie a deux
General hospital psychiatry, 2009Co-Authors: Jessica E. Bury, J. Michael BostwickAbstract:This report presents a patient incorrectly diagnosed first with parasitic infestation and then with primary Delusional Parasitosis (DP). Neither diagnosis was correct. As she traveled from doctor to doctor, however, the primary DP label gained credibility via repetition, with her ongoing symptoms seen as proof of its truth.
Wolfgang Trabert - One of the best experts on this subject based on the ideXlab platform.
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Shared Psychotic Disorder in Delusional Parasitosis
Psychopathology, 1999Co-Authors: Wolfgang TrabertAbstract:Delusional Parasitosis (DP) is associated in 5-15% with shared psychotic disorder (SPD). Little systematic information is available about this particular aspect of the syndrome. A thorough review of all published cases with DP was carried out. 68 case histories of SPD were identified (5.67%). The data of these patients were compared with those of their inducers (n = 44) and with the data of DP patients, who did not transfer their Delusional beliefs to others (n = 1,155). Approximately 30% of the psychotic dyads were reported from public health departments. The sex ratio was balanced in the SPD group, but showed a clear preponderance of females in the other two groups. SPD patients and their inducers reported more frequently visual illusions or hallucinations and located the animals correspondingly upon the surface of the skin. No diagnostic differences were found between the inducers and those who had DP but did not induce SPD in others. Albeit 50% of the SPD patients did not receive any treatment except separation from the inducer, the remission rate in this group was 93%.
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100 Years of Delusional Parasitosis
Psychopathology, 1995Co-Authors: Wolfgang TrabertAbstract:Delusional Parasitosis (DP) is mostly described in single cases or small samples. Data on epidemiology, nosological classification, therapy and course are therefore difficult to interpret. A thorough