Dangerous passion: Othello syndrome and dementia

Abstract

Jealousy is a complex emotion that most people have experienced at some time in life; pathological jealousy refers primarily to an irrational state. Othello syndrome is a psychotic disorder characterized by delusion of infidelity or jealousy; it often occurs in the context of medical, psychiatric or neurological disorders. At least 30% of cases in the literature show a neurological basis for their delusion of infidelity, although its biological basis is not fully understood. The purpose of this paper is to examine the phenomenon of pathological jealousy in people with dementia. We searched the electronic databases for original research and review articles on Othello syndrome in demented patients using the search terms 'Othello syndrome, morbid jealousy, pathological jealousy, delusional disorders, dementia'. Convictions about the partner's infidelities may form the content of psychopathological phenomena, such as delusions. Delusional jealousy is a frequent problem in dementia. Coexistent delusions and hallucinations are frequent. The violence in demented patients suffering from this syndrome is well documented and forensic aspects are highlighted. There are no systematic researches about the clinical characteristics of Othello syndrome in persons suffering from dementia, but only case reports and it is not possible to differentiate or compare differences of delusional jealousy across the various type of dementia or distinguish the syndrome in demented patients from the syndrome in other psychiatric disorders. Frontal lobe dysfunction may be called into question in delineating the cause of the delusional jealousy seen in Othello syndrome.