Ekbom syndrome (delirium of parasitosis): what is it?

Schizophrenia spectrum disorders, abrupt cessation of alcohol consumption in addicted people or head injuries, among other alterations, can cause the appearance of a very peculiar type of delirium: Ekbom syndrome or delusions of parasitosis.

People with this disorder believe that they have insects or other parasites on their skin, and they often continue to hold this idea even when medical tests disprove it. Let's see what causes this delusion and what exactly is it.

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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 pruritus (constant itching in a part of the body that causes an intense urge to scratch).

People with Ekbom syndrome can hold the idea that they have parasites on their skin with great conviction for a long time and despite the evidence to the contrary obtained through medical examinations or other ways. If these conditions are met, the alteration would be classified as a delusional disorder proper.

From other perspectives, Ekbom syndrome is conceived as a psychosis with delusional belief as the only symptom. This is why drugs are sometimes used antipsychotics such as pimozide and olanzapine to treat this disorder, although there are also psychological procedures for the management of delusions and hallucinations.

Other names used to refer to Ekbom syndrome are "Delirium of parasitosis", "delusional parasitosis", "dermatozoic delirium", "parasitic delirium", "Delusion of infestation" and "imaginary parasitosis". The ICD-10 diagnostic manual, which specifically collects this disorder, calls it “delirium of parasitosis”.

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

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Symptoms and clinical picture

Most people with Ekbom syndrome report sensations that they attribute to movements of insects that cross the skin or that move through the internal part of it. This abnormal perception is called "formication." and is part of the phenomena known as paresthesias, which also include pricks or numbness.

While ants are one of the most frequently referred to "parasites" and give names to different terms used to describe refer to Ekbom syndrome, it is also common for people with this disorder to say that they have worms, spiders, lizards and other animals little ones. Sometimes they claim that they are invisible.

Under certain conditions, any person can perceive sensations of formation, especially if there are circumstances that favor them, such as menopause or medical conditions that affect the sensory nerves. However, the generation of the delusional belief is much less common and requires some type of trigger.

There are two broad categories of delusions of parasitosis depending on the nature of the alterations. We speak of primary Ekbom syndrome when symptoms arise in the absence of identifiable problems, and therefore can be attributed to errors in the patient's reasoning. This subtype is similar in nature to the psychosis sharp.

On the other hand, when an underlying alteration that triggers the delusional belief is detected, 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.

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Related disorders and conditions

The appearance of Ekbom syndrome is often associated with an 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 the excessive consumption of cocaine or other stimulants.

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

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

Morgellons syndrome is another variant of delusional parasitosis in which the parasites are replaced by fibers of different types that have had contact with the skin, such as cloth or remains of bandages, or are not identified by the patient. It is a rare disorder that has been studied a little over ten years ago.