What is Delusional Parasitosis?

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  • Written By: Niki Foster
  • Edited By: Andrew Jones
  • Last Modified Date: 17 October 2019
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Delusional parasitosis, or delusions of parasitosis, is a form of psychosis in which the patient believes that he or she is suffering from parasitic infestation, when in reality there is no such infestation. Often, the patient describes the imagined parasites as bugs crawling over or under the skin. Formication, the medical term for a crawling sensation on the skin, such as the "pins and needles" that can arise when circulation to an extremity is temporarily cut off, may be the basis for some cases of delusions of parasitosis.

Delusional parasitosis is sometimes referred to as Ekbom's syndrome, after 20th century Swedish neurologist Karl Axel Ekbom. However, Ekbom worked on both delusions of parasitosis and restless leg syndrome, and either condition may be referred to as Ekbom's syndrome. The two disorders are very different, however, as restless leg syndrome has physical causes and delusional parasitosis is a psychological condition.

Patients with delusional parasitosis often collect what they believe to be evidence of their infestation, such as small marks on the body or clothing. They are capable of injuring themselves, for example through excessive scratching, and sometimes convince others, such as those they live with, that they are also infested. A variety of the delusion, delusory cleptoparasitosis, is characterized by a belief that one's dwelling is infested with parasites, rather than one's person.


Delusional parasitosis may be divided into three categories. These are primary, secondary functional, or secondary organic. In primary delusional parasitosis, the psychosis presents on its own, without any accompanying disorders or causes. In the secondary functional variety, another psychiatric condition is present, such as schizophrenia or depression.

In secondary organic delusions of parasitosis, the psychosis is caused by a medical illness, medication, or recreational drug use. Some medical conditions that can cause delusional parasitosis include diabetes mellitus, tuberculosis, cancer, and neurological disorders. Menopause, allergies, poor nutrition, and drug abuse can also be underlying causes of delusions of parasitosis.

Patients with delusions of parasitosis are often misdiagnosed or misunderstood, as they typically do not realize that their condition is psychological. They are more likely to seek help from a dermatologist than a psychiatrist and may refuse psychiatric treatment. If delusional parasitosis is a secondary condition, it is treated by treating the primary condition, or cause. Whether primary or secondary, delusions of parasitosis are often very difficult to treat because the patient rejects a psychological explanation of his or her symptoms.


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Post 3

Right. Until it is scabies, which just happen to be mites that burrow into human skin and are microscopic and can't be seen the way lice can be. It is probably not psychosis. It is probably the result of a crappy med school. You need permetherin in a lotion suspension. It's $50 a tube and requires a prescription. Get a different doctor. If they are from Illinois say chigger. Chiggers live in tall grass in Illinois and will burrow under the surface of the skin. Scabies need a human host to complete their life span but they can live on furniture, linens, clothes, and carpets for something like 10 days so you need to spray all of that stuff so you don't get then again. Sometimes you need to do a second round of treatment. Horrible little things. You can catch them if you are high or sober. Scabies doesn't care.

Post 2

@SZapper - Hallucinogens can make people do crazy things. When I was younger my mom told me this story about having to physically stop a friend from jumping out a window when she was tripping on acid. The girl had gotten it into her head that she could fly! I think that story stopped me from experimenting with drugs when I was in high school.

I actually have a friend that was diagnosed with delusion parasitosis. However, she turned out to actually have parasites. The poor girl had bird mites! These sneaky pests actually sometimes will pick one household member to infest, so the rest of the household wasn't experiencing any symptoms. They are also very small, and hard to


Eventually she was able to find a doctor who believed her, and had some experiences with these mites. They did some tests and found out she did in fact, have bird mites. Getting rid of them was a whole other battle though.

Post 1

Recreational drug use can definitely cause delusional parasitosis. I'm not a drug user myself, but I once had the unfortunate experience of watching someone have a "bad trip" on a hallucinogenic drug.

I was at a party, and I was getting ready to leave. Once I realized there were drugs around I decided to call it a night. However, just as I was getting my things together another party goer started freaking out, scratching herself, and screaming about how there were bugs on her and to get them off, etc. Of course there were no bugs on her anywhere!

A few of her friends tried to calm her down, but they were ultimately unsuccessful. Eventually an ambulance was called, and I took that moment to make my exit. I never did find out what happened to that girl, but hopefully everything turned out all right. I doubt she ever did any hallucinogens after that!

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