The unusual case of delusional parasitosis or ekbom syndrome

Delusional parasitosis is a rare mental health condition that is also known as Ekbom syndrome. We can understand this psychiatric issue by dividing the term into two parts. The person experiences delusions, or false fixed beliefs, even in the face of contrary evidence. This means that even if the doctor shows them evidence, they are likely to not believe it. The second part is 'parasitosis' which is indicated for parasites.

Delusional parasitosis is a condition in which people fervently believe that parasites are infesting their bodies. Insects such as spiders, dragonflies, and fleas are among the most commonly complained of.

Delusional parasitosis is a rare and complicated mental health condition. (Image via Pexels/ Nikita Igonkin)

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Symptoms and causes of delusional parasitosis

It is an atypical condition often requiring medications. (Image via Pexels/ Mart Production)

A characteristic feature of this condition is that patients may show ‘the matchbox sign’ by bringing specimens of the alleged organisms. This means they may scratch or use sharp objects to get the parasites out of their skin.

Numerous illnesses, such as schizophrenia, organic brain disease, neurosis, and paranoid personality disorder, are linked to Ekbom's syndrome. Additionally, it's been documented in certain cases of alcohol withdrawal, cocaine abuse, strokes, dementia, and lesions in the thalamus. As you may notice, it can develop potentially from various types of conditions.

Patients with Ekbom's syndrome frequently refuse psychological therapies because they are certain that medical intervention is necessary to address the condition. Sometimes, isolating effects can reinforce their false beliefs, further worsening their disconnection with reality. They may also experience visual hallucinations and report that they can see insects.

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Delusion of parasitosis treatment

Is there an available treatment for this psychiatricc disorder ? (Image via Freepik/ ijeab)

Generally, patients start seeking medical help for their symptoms. Therapy may initially fail since the patient sees tactile hallucinations as evidence for their symptoms. They may see therapy as potentially invalidating. However, this doesn't mean it's not important. Rather, therapy can be introduced at a later point, when the patient feels ready.

The primary treatment for delusional parasitosis is antipsychotic medication. These may be used to reduce distress and help avoid further psychotic breaks. However, the impact of medications can vary from person to person.

They may also benefit from psycho-education about their symptoms. This may also include informing the patient's family members about delusional parasitosis. It can be quick for us to jump to conclusions or make judgements about the patient; however, it is not something that they are engaging in voluntarily. By becoming aware and finding treatments that support the patient, we can move towards stabilising them.

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Ekbom syndrome can be an isolating and complex condition. While the exact ways to manage this condition are not clearly known, seeking early treatment is better. If you notice delusional parasitosis symptoms in your loved ones, try to direct them towards psychiatric care. You may notice that they spend a lot of time searching for evidence that proves their beliefs. While their beliefs can't change overnight, they can learn to explore them in a safer environment.

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Janvi Kapur is a counselor with a Master's degree in applied psychology with a specialization in clinical psychology.

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