Document Type
Manuscript
Submission Date
2025
Abstract
Primary delusions of parasitosis (PDOP) is a rare psychiatric condition defined by a fixed false belief of parasitic infestation without an underlying medical explanation. Despite an estimated prevalence of 1.48 cases per million, dermatologists and primary care physicians frequently encounter affected patients. Although antipsychotics achieve remission in 60-75% of cases, treatment is often hindered by patients’ refusal to accept psychiatric explanations or medications, leading to harmful behaviors such as pesticide application, employment challenges, or strained social connections.
This paper sought to address the challenge of treatment acceptance by developing a practical, clinician-friendly communication script. A literature review of PubMed articles informed the initial draft, which was iteratively revised through interviews with six dermatologists, three psychiatrists, and three primary care physicians. The resulting script emphasizes empathetic rapport, structured handling of patient “specimens,” judicious medical work-up, and tactful language for introducing antipsychotic medications. Key strategies include validating distress, framing medications as treatments for itching and discomfort rather than psychiatric disease, and offering pimozide as a non-psychiatric alternative when appropriate.
Participating clinicians reported high satisfaction with the script’s applicability and usefulness. Future studies should evaluate its real-world impact on treatment initiation, adherence, and patient outcomes. By equipping physicians with tailored conversation tools, this project aims to improve rapport, reduce patient isolation, and increase acceptance of evidence-based treatment. Ultimately, this communication-based approach may mitigate the burden of PDOP, restoring quality of life for patients while easing clinical frustrations in managing this challenging disorder.
Recommended Citation
Goodrich, Isabel and Rabinowitz, Terry, "Primary Delusions of Parasitosis: Finding an Effective Clinical Approach" (2025). Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects. 57.
https://scholarworks.uvm.edu/m4sp/57
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Poster
Included in
Mental Disorders Commons, Other Mental and Social Health Commons, Other Psychiatry and Psychology Commons, Psychiatric and Mental Health Commons, Psychiatry Commons, Psychological Phenomena and Processes Commons