Psychiatry Service, Department of Psychiatry and Mental Health, Local Health Unit of Lower Alentejo, Rua Dr. Antonio Fernando Covas Lima, 7801-849, Beja, Portugal.
BMC Psychiatry. 2020 Oct 23;20(1):516. doi: 10.1186/s12888-020-02921-5.
Erotomania, also known as "de Clérambault's Syndrome", is a psychiatric syndrome characterized by the delusional belief that one is loved by another person of, generally of a higher social status. Erotomania has always been a target of attempts of conceptualization, and the utility of regarding Erotomania as an independent syndrome has been questioned to this day. Erotomania has a much higher prevalence in the female sex, and male Erotomania is a rare and probably underdiagnosed condition. Male Erotomania is only more prevalent in forensic samples, since male sex is one of the risk factors for violent behavior in this disorder. In this article, we aim to describe an uncommon case of Erotomania occurring in a male, hoping to add to literature and to reflect on the implications of the occurrence of Erotomania in men. By discussing the case in light of the different described clinical pictures, proposed diagnostic criteria and classifications, we also aim to contribute to the ongoing attempt to conceptualize this syndrome and to understand the pertinence of considering it an independent nosological entity.
We describe a case of Erotomania in a middle-aged Caucasian Portuguese male, with consecutive erotic delusions, followed by a classic turn to a persecutory delusion. The patient was admitted as an inpatient in a psychiatry unit and he was medicated with risperidone 3 mg and diazepam 3 mg daily. His persecutory delusion remitted a 4 days later, he gained insight and was discharged to follow-up as an outpatient. He retains his erotic delusional beliefs, but these are less intense, and has not presented further aggressive behavior.
We can conclude that it seems reasonable to retain the operative concept of Erotomania as a subtype of Persistent Delusional Disorder/Delusional Disorder, since cases fitting the classical descriptions of the syndrome have been reported, including the presented case. The diagnosis of Erotomania has implications in case management, treatment and prognosis, and missing it, especially in men, may culminate in violent situations that can have legal implications. The developed diagnostic criteria and classifications seem to retain use and should be kept in mind, in the sense that they facilitate making an important diagnosis.
钟情妄想，又称“德克拉朗布埃综合征”，是一种精神科综合征，其特征是妄想他人，通常是社会地位较高的人爱慕自己。钟情妄想一直是概念化尝试的目标，将钟情妄想视为一种独立综合征的效用至今仍受到质疑。钟情妄想在女性中更为常见，而男性钟情妄想则是一种罕见且可能诊断不足的情况。男性钟情妄想仅在法医样本中更为常见，因为在这种疾病中，男性性别是暴力行为的一个风险因素。在本文中，我们旨在描述一例罕见的男性钟情妄想病例，希望能为文献增砖添瓦，并反思男性发生钟情妄想的意义。通过结合不同描述的临床表现、提出的诊断标准和分类来讨论该病例，我们也旨在为持续尝试对该综合征进行概念化以及理解将其视为独立的疾病实体的相关性做出贡献。
我们描述了一例中年白种葡萄牙男性的钟情妄想，随后出现连续的色情妄想，继而出现典型的迫害妄想。该患者被收入精神病院住院治疗，每天接受利培酮 3mg 和地西泮 3mg 治疗。他的迫害妄想在 4 天后缓解，他获得了洞察力并出院接受门诊随访。他仍然存在色情妄想信念，但强度较低，且未表现出进一步的攻击性行为。
我们可以得出结论，保留钟情妄想作为持续性妄想障碍/妄想障碍的一种亚型的操作性概念似乎是合理的，因为已经报道了符合该综合征经典描述的病例，包括所介绍的病例。钟情妄想的诊断对病例管理、治疗和预后具有重要意义，如果遗漏，尤其是在男性中，可能会导致暴力情况，从而可能产生法律影响。所制定的诊断标准和分类似乎仍具有一定的使用价值，应牢记在心，因为它们有助于做出重要的诊断。
