Ekbom syndrome (parasitic delirium): causes and symptoms

Schizophrenia spectrum disorders, abrupt cessation of alcohol use in drug addicts or head trauma, among other disorders, can lead to the development of a very specific type of delirium: Ekbom syndrome or parasitic delirium.

People with this disorder believe they have bugs or other parasites on their skin and often continue to have this idea even though medical examinations deny it. Let’s see what causes it and what exactly this delirium consists of.

    What is Ekbom Syndrome?

    Ekbom syndrome is a psychological disorder characterized by delusional belief that the person has insects under the skin or other small parasites. This alteration is associated with the presence of tactile hallucinations and itching (constant itching in one part of the body that causes an intense urge to scratch).

    People with Ekbom syndrome can support with great conviction the idea that they have parasites on their skin for a long time and despite the evidence against it obtained through medical examinations or otherwise. If these conditions are given, the impairment would be classified as a delusional disorder per se.

    From another point of view, Ekbom syndrome is conceived as psychosis with delusional belief as the only symptom. This is why antipsychotic drugs such as pimozide and olanzapine are sometimes used to treat this disorder, although there are also psychological procedures to manage delusions and hallucinations.

    Other names used to refer to Ekbom syndrome are “Parasitic delusions”, “delusional parasitosis”, “dermatozoic delusions”, “parasitic delusions”, “Delirium Infestation” and “Imaginary Parasitosis”. The CIE-10 Diagnostic Manual, which specifically covers this disorder, calls it “parasitic delirium”.

    This disorder is more common in women, especially from the fifth decade of life. Some experts attribute this fact in part to the onset of menopause, which is associated with the appearance of abnormal sensory phenomena to which the person could give a delusional interpretation, thus causing Ekbom syndrome.

      Symptoms and clinical picture

      Most people with Ekbom syndrome report sensations that they attribute to the movements of insects that pass through the skin or move inside the skin. This abnormal perception is called “formicación” and is among the phenomena known as paresthesias, which also include punctures or numbness.

      While ants are one of the most commonly referred to as “parasites” and give names to the various terms used to refer to Ekbom syndrome, it is also common for people with this disorder to say that they have worms. , spiders, lizards and other small animals. . Sometimes they claim that these are invisible.

      Under certain conditions, any person can perceive sensations of formicación, especially if circumstances occur that cause them, such as menopause or medical conditions that affect the sensory nerves. However, the generation of delusional beliefs is much less common and requires some sort of trigger.

      There are two main categories of parasitic delusions depending on the nature of the alterations. We speak of primary Ekbom syndrome when the symptoms appear in the absence of identifiable problems, and can therefore be attributed to errors in the patient’s reasoning. This subtype is similar in nature to acute psychosis.

      In contrast, when an underlying alteration is detected that triggers the delusional belief, the disorder is classified as secondary. In turn, this type is divided into two: functional, which is diagnosed in cases where the syndrome is due to a psychiatric disorder such as schizophrenia, and organic, when the cause is a disease or a drug.

        Associated disorders and alterations

        The onset of Ekbom syndrome is often associated with overactivation of the body due to the consumption of certain substances. In particular, delusional parasitosis in many cases is due to withdrawal syndrome in people with alcohol dependence or excessive use of cocaine or other stimulants.

        In addition to psychotic disorders, other alterations in the structure and functioning of the brain may explain the appearance of this disorder. Neurodegenerative diseases (including alcoholic dementia) and traumatic brain injury, for example, are two common causes of Ekbom syndrome.

        It is worth mentioning also delusional kleptoparasitosis, which is considered a subtype of Ekbom syndrome. In this variant, the person does not maintain the belief that there are bugs in their skin, but that they infest their residence and therefore run the risk of being parasitized. However, it is possible and common for both disorders to occur at the same time.

        Another variant of parasitic delirium is Morgellons syndrome in which the parasites are replaced by fibers of different types which have been in contact with the skin, such as tissue or remains of bandages, or which are not identified by the patient. It is a rare disorder that was studied a little over ten years ago.

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