Namboodiri Sally, Rao Sanjay
Medicine, Louis Stokes Cleveland VA Medical Center, Cleveland, USA.
Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Cureus. 2025 Jun 4;17(6):e85322. doi: 10.7759/cureus.85322. eCollection 2025 Jun.
Patients with somatic delusional disorder are firmly convinced that something is wrong with their bodies and are often referred from one specialist to another without receiving a clear diagnosis. Some of these patients may turn to complementary or alternative medicine based on information found through online health searches. However, online health content is not regulated for quality, and much of it is inaccurate or potentially harmful, including fad diets and vitamin supplement advice from celebrity doctors. We present the case of a patient who believed he had Huntington's disease and developed cyberchondria - compulsive online health searching - in an effort to treat his perceived condition. His distrust of conventional healthcare and reliance on unverified online sources led to a restrictive diet and excessive intake of dietary supplements, ultimately resulting in vitamin D toxicity, acute hypercalcemia, and renal failure. Managing patients with somatic delusions is challenging, as they often lack insight into their underlying psychiatric condition. A useful approach involves building a trusting relationship with a specialist familiar with the area of the somatic complaint. This relationship can help explore the patient's symptoms and emotional stressors, eventually allowing for a gentle and gradual challenge to the delusional beliefs.
患有躯体妄想障碍的患者坚信自己身体有问题，常常辗转于各个专科医生之间，却得不到明确的诊断。其中一些患者可能会根据网上健康搜索的信息求助于补充医学或替代医学。然而，网上健康内容的质量并未受到监管，其中很多是不准确的或有潜在危害的，包括时尚饮食法以及明星医生给出的维生素补充建议。我们报告一例患者，他认为自己患有亨廷顿舞蹈症，并产生了网络疑病症——强迫性地在网上搜索健康信息——试图治疗他所认为的病症。他对传统医疗保健的不信任以及对未经证实的网络信息源的依赖，导致了饮食限制和膳食补充剂的过量摄入，最终造成维生素D中毒、急性高钙血症和肾衰竭。管理患有躯体妄想的患者具有挑战性，因为他们往往对自己潜在的精神状况缺乏洞察力。一种有效的方法是与熟悉躯体主诉领域的专科医生建立信任关系。这种关系有助于探究患者的症状和情绪压力源，最终温和而逐步地挑战其妄想信念。
