Räsänen P, Erkonen K, Isaksson U, Koho P, Varis R, Timonen M, Leinonen E, Isohanni M, Alanko A
Department of Psychiatry, University of Oulu, Finland.
Int Psychogeriatr. 1997 Dec;9(4):459-64. doi: 10.1017/s1041610297004596.
A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in "matchboxes" to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.
患有妄想性寄生虫病的患者坚信自己感染了寄生虫，比如虱子或蠕虫。即便被告知没有寄生虫且检测结果也证实不存在寄生虫，这类患者仍不满意，甚至会把装在“火柴盒”里的寄生虫带给医生看。患者主观上感到担忧，可能会试图从皮肤上揪出寄生虫，从而导致皮肤损伤甚至溃疡。根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R），该病症被归类为妄想/偏执型障碍，躯体类型。从流行病学角度对这种罕见病症了解不多，它通常影响老年女性，这些女性往往在社交上比较孤立。治疗被认为很困难，人们尝试了各种各样的治疗方法。本文介绍了六个女性病例，表明典型患者是遭受过损失或在社交上孤立的老年女性。这些患者对自己的问题缺乏更深入的精神科洞察力，所以大多由非精神科医生照料。低剂量强效抗精神病药物有时联合抗抑郁药进行治疗似乎有效。减少社交孤立也很重要。
