Kelly Brendan D
Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland.
CNS Drugs. 2005;19(8):657-69. doi: 10.2165/00023210-200519080-00002.
Erotomania is generally classified as a delusional disorder in contemporary classification systems (DSM-IV and ICD-10). The incidence of erotomania is not known, but that of delusional disorder in general has been reported as approximately 15 cases per 100,000 of the population per year, with a female : male ratio of 3 : 1. Both primary and secondary types of erotomania have been identified, the latter being associated with evidence of an aetiologically significant organic or psychiatric condition. The aetiology of primary erotomania is not yet fully understood, but neuroimaging, genetic studies and findings from evolutionary psychopathology hold considerable promise for a deeper and broader understanding of this condition. The initial management of secondary erotomania focuses on treating the underlying organic or psychiatric illness. The management of primary and secondary erotomania involves a combination of pharmacological treatments, psychosocial interventions and risk management strategies. In the past, the antipsychotic medication pimozide was commonly used, at least in certain countries (such as the US and Canada), despite a paucity of systematic studies of its use in this disorder. In recent years, there have been reports of positive therapeutic outcomes with atypical antipsychotics (risperidone, clozapine), which, as a result of their improved tolerability over older agents such as pimozide, will hopefully enhance patient acceptability and, thereby, improve clinical outcome. Despite this advance, there is still a strong need for controlled clinical trials of therapeutic strategies for primary erotomania and related syndromes.
在当代分类系统（《精神疾病诊断与统计手册》第四版和《国际疾病分类》第十版）中，色情狂通常被归类为一种妄想障碍。色情狂的发病率尚不清楚，但据报道，一般妄想障碍的发病率约为每年每10万人中有15例，女性与男性的比例为3:1。已确定了原发性和继发性色情狂类型，后者与具有病因学意义的器质性或精神疾病证据相关。原发性色情狂的病因尚未完全了解，但神经影像学、基因研究以及进化精神病理学的研究结果有望为更深入、更广泛地理解这种疾病带来希望。继发性色情狂的初始治疗重点是治疗潜在的器质性或精神疾病。原发性和继发性色情狂的治疗包括药物治疗、心理社会干预和风险管理策略的综合应用。过去，抗精神病药物匹莫齐特通常被使用，至少在某些国家（如美国和加拿大）是这样，尽管对其在这种疾病中的应用缺乏系统研究。近年来，有报道称非典型抗精神病药物（利培酮、氯氮平）取得了积极的治疗效果，由于它们比匹莫齐特等老药耐受性更好，有望提高患者的接受度，从而改善临床结果。尽管有这一进展，但对于原发性色情狂和相关综合征的治疗策略仍迫切需要进行对照临床试验。
