Xu Tian, Li Zhao-Sheng, Fang Wei, Cao Lan-Xiao, Zhao Guo-Hua
Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322200, Zhejiang Province, China.
World J Clin Cases. 2022 Jan 21;10(3):1024-1031. doi: 10.12998/wjcc.v10.i3.1024.
Othello syndrome (OS) is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner, which may lead to extreme behaviors. Impulse control disorders refer to behaviors involving repetitive, excessive, and compulsive activities driven by an intense desire. Both OS and impulse control disorders in Parkinson's disease (PD) may be side effects of dopamine agonists. At present, there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.
We describe a 70-year-old male patient with PD, OS, and impulse control disorders, who presented with a six-month history of the delusional belief that his wife was having an affair with someone. He began to show an obvious increase in libido presenting as frequent masturbation. He had been diagnosed with PD ten years earlier and had no past psychiatric history. In his fourth year of PD, he engaged in binge eating, which lasted approximately one year. Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.
Given its potential for severe consequences, OS should be identified early, especially in patients undergoing treatment with dopamine agonists.
奥赛罗综合征(OS)的特征是存在关于配偶或性伴侣不忠的妄想信念,这可能导致极端行为。冲动控制障碍是指由强烈欲望驱动的涉及重复性、过度性和强迫性活动的行为。帕金森病(PD)中的OS和冲动控制障碍都可能是多巴胺激动剂的副作用。目前,仅有少数与伴发OS和冲动控制障碍的PD相关的病例报告和研究。
我们描述了一名70岁患有PD、OS和冲动控制障碍的男性患者,他有6个月认为妻子与他人有婚外情的妄想信念病史。他开始出现性欲明显增强,表现为频繁手淫。他10年前被诊断为PD,既往无精神病史。在患PD的第4年,他出现暴饮暴食,持续约1年。在减少普拉克索剂量并开具喹硫平处方后,OS和性欲亢进均得到显著缓解。
鉴于OS可能产生严重后果,应尽早识别,尤其是在接受多巴胺激动剂治疗的患者中。