Abstract Details

Title Delusional Parasitosis: A Systematic Review of Cases

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-011

Objective This systematic review aims to summarize the current evidence from case reports on patients with delusional parasitosis.

Background Delusional parasitosis (DP), also known as Ekbom syndrome, is a rare psychiatric disorder characterized by a persistent false belief of being infested with parasites despite the absence of any medical evidence. Although its exact pathophysiology remains unclear, DP is frequently associated with underlying psychiatric, neurological, or even infectious conditions.

Design/Methods We searched four databases (PubMed, Embase, Scopus, Web of Science) from August 2015 to August 2025. We included 122 case reports and case series describing the clinical, diagnostic, and treatment characteristics of patients with DP. No meta-analysis was performed due to the heterogeneity of the data. The JBI critical appraisal tool was used to assess the risk of bias of case reports and cases series.

Results We included 122 case reports of patients with DP. The mean age of onset ranged from 56 to 67 years with a female-to-male ratio of 3:1. The primary clinical manifestations included a fixed false belief of infestation (100%), formication (100%), and pruritus (80%). Patients commonly presented with self-induced skin lesions due to scratching and picking, including excoriations, lichenification, and scarring. A majority of patients (80%) had a past or comorbid psychiatric condition, most commonly depression (74%), followed by substance abuse (25%), and anxiety (20%). Regarding treatment, most patients were managed with second-generation (atypical) antipsychotics. First-line recommendations included risperidone and aripiprazole, while olanzapine and first-generation antipsychotics were typically considered second-line options.

Conclusions

In conclusion, delusional parasitosis is highly associated with other psychiatric comorbidities, and second-generation antipsychotics is the first line of therapy. However, future prospective studies and clinical trials are required to establish more robust evidence for optimal management strategies.

Authors/Disclosures
Margarita I. Chuquin PRESENTER	Mrs. Chuquin has nothing to disclose.
Jeancarlo Velazco Muñoz	Mr. Velazco Muñoz has nothing to disclose.

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