Erotomanic Delusions Research Articles

Les Psychoses Passionnelles: A Rare Case Report of Multiple Erotomanic Delusions in a Male

Abstract Les psychoses passionnelles, or simply put, erotomanic delusions, is a rare, cryptic psychiatric entity with a wide range of presentations in history. Mostly seen in women, this condition has no known etiology and has a variable prognosis and response to treatment. We present a rare case of multiple erotomanic delusions in a man hailing from Southern India. He has lived with this condition for the past 5 years and has been nonresponsive to antipsychotics. The behavior of such patients can lead to the social embarrassment of friends and family. Serious cases in men also result in violence, although this is very rare. This necessitates the need to get to the core of this syndrome. More research is needed to understand the cause of this condition and find an effective treatment.

Deciphering the Neuropsychiatric Landscape of Huntington’s Disease: Insights and Implications—A Case Report

Huntington’s disease (HD) is an autosomal dominant neurodegenerative illness with a specific phenomenology that includes chorea, incoordination, dystonia, behavioral difficulties, and cognitive decline. The most frequent cause of inherited chorea manifesting in adults is HD, which affects approximately 5 per 100,000 to 12 per 100,000 people. This case report describes the case of a 42-year-old woman from Assam who had been experiencing progressive and gradual onset choreiform movements of both upper limbs, affecting the fingers and face for the last two years, along with an unsteady gait and slurred speech and lack of personal care and hygiene. She also developed psychotic manifestations in the form of erotomanic delusions along with decreased sleep, restlessness, and disorganized behavior. A positive family history of dementia in their maternal grandmother and movement disorder in their paternal grandmother, along with the history of the death of her elder brother at birth, was present. The patient was admitted considering HD as a provisional diagnosis, and treatment with tablets tetrabenazine, olanzapine, risperidone, and lorazepam for her behavioral and movement symptoms was initiated. Her magnetic resonance imaging (MRI) brain report showed caudate atrophy. HD repeat expansion analysis that revealed full penetrance expansion of approximately 46 coronary angiogram (CAG) repeats in either allele was confirmatory of HD. There was an improvement in her symptoms seen in two follow-up visits to the outpatient department (OPD) after discharge except for reduced sleep; hence, melatonin 10 mg was added for it. Middle-aged patients presenting to psychiatrists with choreiform movement and psychiatric symptoms along with a positive family history should raise the suspicion of HD.

Copy number deletion of PLA2G4A affects the susceptibility and clinical phenotypes of schizophrenia

Phospholipase A2(PLA2) superfamily is recognized as being involved in the pathogenesis of schizophrenia by affecting lipid homeostasis in cell membranes. We hypothesized that PLA2 gene copy number variation (CNV) may affect PLA2 enzyme expression and be associated with schizophrenia risk. This study indicated that in the discovery stage, an increased copy number of PLA2G6 and the deletion of PLA2G3, PLA2G4A, PLA2G4F and PLA2G12F was associated with increased risk of schizophrenia. CNV segments involving six PLA2 genes were detected in publicly available datasets, including two deletion segments specific to the PLA2G4A gene. The relationship between the deletion of PLA2G4A and susceptibility to schizophrenia was then reaffirmed in the validation group of 806 individuals. There was a significant correlation between PLA2G4A deletion and the symptoms of poverty of thought in male patients and erotomanic delusion in females. Furthermore, ELISA results demonstrate a significant decrease in peripheral blood cytosolic PLA2(cPLA2) levels in patients with the PLA2G4A deletion genotype compared to those with normal and copy number duplicate genotypes. These data suggest that the functional copy number deletion in the PLA2G4A gene is associated with the risk of schizophrenia and clinical phenotypes by reducing the expression of cPLA2, which may be an indicator of susceptibility to schizophrenia.

Induced erotomania by online romance fraud - a novel form of de Clérambault’s syndrome

BackgroundAlthough the impact of internet usage on mental health is extensively documented, there is a notable scarcity of reports in the literature concerning internet-induced erotomania. Erotomania is a rare and likely underdiagnosed delusional disorder. It is characterized by an irrational belief held by the affected persons that someone of higher socioeconomic status harbor romantic feelings toward them. Here, we describe the psychopathology of erotomanic delusion induced by online romantic fraud in a female patient. Employing this case as a focal point, we illuminate novel aspects of erotomania that warrant attention and examination.Case presentationWe present a compelling case involving a 70-year-old married Caucasian woman diagnosed with medically controlled persistent depressive disorder for several years. The intricacies of her condition became evident as she became deeply engrossed in online profiles featuring the image of a renowned musician, inadvertently falling victim to an online romantic fraud. Subsequently, this distressing experience triggered the emergence of erotomanic delusions and a suicide attempt. The patient's history reveals an array of medical conditions and stressful life events, contributing to her vulnerability. The diagnosis of erotomanic delusional disorder, dysthymia, and mild cognitive impairment with cerebral vascular background was established. Treatment involved her previous antidepressant with low-dose risperidone, alongside supportive individual and group therapy. Her delusion showed remission four weeks later, prompting her discharge for outpatient follow-up. Although she retained some false beliefs, the intensity of the symptoms had notably diminished and her functionality improved.ConclusionThis case underscores the complex interplay between mental health, online activities, and the consequences of delusions, including suicidal thoughts, shedding light on the need for a comprehensive approach in addressing such challenging psychiatric scenarios.

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INTRODUCTIONStalking is generally defined as an intentional pattern of repeated intrusive and intimidating behaviours towards a specific person that causes the target to feel harassed, threatened and fearful. Motivations for stalking include a delusional belief in romantic destiny, a desire to reclaim a prior relationship, a sadistic urge to torment the victim or a psychotic over identification with the victim and the desire to replace him or her. Cyberstalking can be as distressing to victims as physical stalking if not more so, due to the concealment and anonymity afforded by electronic communication.CASE REPORT21 years old male patient had sleeplessness, hearing voices, easy irritability, harming self, breaking articles and sending threatening messages to an unacquainted celebrity actress for 5 months. He was distressed with the voices of the celebrity actress accusing him. He decided to threaten her and followed her social media activities and was cyberstalking for 4 months, sending threatening messages to her Facebook, Instagram and whatsapp accounts and she eventually sorted legal help.While in stalkers, erotomanic delusions are the commonly reported delusions, other delusional fixations like persecutory type are rarely reported.

Google assistant, she loves me

Although modern technologies have made life simpler, it has also intensified the complexity of psychopathology. The adoption of the Internet and its numerous artificial intelligence software products into morbid delusions is gaining more momentum. Clinicians must be alert about patients with delusions getting ideas and feedback from the social context in which they live. Here, we discuss a case about a young, single, high-school graduated male, with schizoid personality traits, socially withdrawn, dependent, sexually inhibited with a poor level of occupational and social functioning, who has developed erotomanic delusion with Google Assistant.

Stalking risks to celebrities and public figures

SUMMARYProminent figures are frequently subjected to unwanted and intrusive attentions. Such stalking behaviour is often driven by psychotic illness, angrily blaming the public figure for delusional persecution (resentful motivation), or based on erotomanic delusions (intimacy seeking motivation), for example. This behaviour can cause psychological harm to both perpetrator and victim, and is unlawful. In the rare instances where a public figure has been attacked, the perpetrator has usually had a history of such stalking behaviour and of severe mental illness. For these reasons, early identification and diversion into appropriate care and treatment will be for the benefit of both parties and will prevent more serious violence in a minority of cases. The importance of the provision of education to improve both reporting rates by victims and an appropriate response from the criminal justice system is highlighted. A multi-agency approach involving the criminal justice system and mental health services is the most effective means of achieving these aims.DECLARATION OF INTERESTNone.LEARNING OBJECTIVES•Learn that severe mental illness, particularly psychosis, is often an important driver of stalking behaviour•Learn that delusional disorder is a treatable mental illness•Appreciate that prevention rather than prediction is the approach to managing the risks of high-harm low-probability outcomes.

Love as delusion, delusions of love: erotomania, narcissism and shame

Erotomania has a long, colourful history in psychiatry. It is a rare condition in which the patient (‘subject’) develops the belief that he or she is loved from afar by...

A Case of erotomanic delusion in dementia

IntroductionIn dementia, delusions are common with prevalence up to 75%. However, erotomanic delusions, or De Clerambault's syndrome, are a rarity in dementia. To date, only six case-reports have been described in vascular dementia, frontotemporal dementia, and Alzheimer's dementia.ObjectivesTo present a case of De Clerambault's syndrome in an older adult diagnosed with vascular dementia.AimsTo review available literature on De Clerambault's syndrome in dementia.MethodsA case report is presented and discussed followed by a literature review.ResultsWe report a 72-year-old female with a history of right posterior cerebral artery infarction. The patient developed a sudden onset erotomanic delusion after she met a male patient of her age during her stay in a dementia day care center. She was agitated, disorientated, presented with confabulation, and showed a dysphoric mood. On MMSE she scored 14/30, the clock-drawing test revealed visuospatial deficits. On MRI, the right occipital lobe showed an encephalomalacia. The patient was treated with sertraline 50 mg/day and olanzapine 5 mg/day. Her erotomanic delusions improved after 3 months of treatment.ConclusionDe Clerambault's syndrome is a rare and poorly understood disorder with generally a poor response to treatment. Some cases were successfully treated with atypical anti-psychotics. However, further research is needed to explore the course and treatment of this delusion.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Erotomania: A psychodynamic overview

IntroductionErotomania is a delusional disorder in which one believes to be loved by someone else. Even though its etiology is not known, psychodynamic factors have been proposed as a possible explanation.ObjectivesTo review the psychodynamic etiology of erotomania.MethodsA search of the Medline/Pubmed database was conducted using the terms “erotomania” and “psychodynamic”.ResultsSeveral authors wrote about the psychodynamic etiology of erotomania. Kraepelin describes it as a “compensation for the disappointments of life”. De Clérambault highlights the idea of “sexual pride”: stimulated by the absence of affective and sexual approval, erotomania flourishes as a way of satisfying the individual's pride. Hollender and Callahan explain the disorder as a result of an ego deficit of not feeling attractive enough. According to Segal, the erotomanic delusion meets the patient's need for love and it is related to the idea of it as the ultimate way of approval. Taylor highlights the patients’ isolation, loneliness and extreme dependence on others.ConclusionsAbout every author agrees with the idea that the erotomanic delusion acts as a gratification to the individual's narcissistic needs, when personal experience has failed to do so. Wanting to be loved is the core of human motivation and the delusion most commonly appears in people who feel rejected by society; facing that perceived rejection, it emerges as the fantasy that other human being is in love with them. This is a relevant overview of this disorder with implications in patients’ treatment, since psychotherapy could be important along with drug treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Gender Differences in Persistent Delusional Disorder.

Byline: Karishma. Kulkarni, Rashmi. Arasappa, M. Prasad, Amit. Zutshi, Prabhat. Chand, Pratima. Murthy, Kesavan. Muralidharan Sir, Few studies have examined gender differences in persistent delusional disorder (PDD), which itself are under researched. Available literature suggests that PDD is slightly more predominant in females, who tend to have a later age at the onset of illness. Females have also been found to have better treatment response as compared to males, perhaps due to better adherence and treatment-seeking behavior.[sup][1],[2],[3] Some studies have reported erotomanic delusions as being more common in females. Others have reported that persecution is the most common theme of delusions among both males and females, with no gender differences in the content of delusions or comorbid depression.[sup][4] Substance dependence is reportedly more common among males with PDD.[sup][2] We examined gender differences in PDD at a tertiary care center in India. Ethical clearance for the study was obtained from the Institute Ethics Committee. We reviewed the case records of 455 patients with PDD (males: n = 236 [51.9%]; females: n = 219 [48.1%]) as part of a retrospective review published earlier.[sup][5] We examined gender differences on age, sociodemographics, illness variables including age at the onset of illness, duration of illness, family history, clinical and treatment details, occupational functioning, number of follow-ups, and hospitalizations. For between-group comparisons, independent samples t -test was used for continuous variables and Chi-square test for categorical variables. The two groups were comparable on age (females: 40.2 [+ or -] 11.2 years vs. males: 38.7 [+ or -] 11.3 years; t = 1.3, P = 0.7). There were no gender differences on sociodemographic variables, including marital status, the mean age at onset, and the mean duration of illness (all P > 0.2). We did not find gender differences in the phenomenology of the primary delusions; the delusion of infidelity ( ? [sup]2 = 0.03; P = 0.8) was the most common in both groups followed by persecution ( ? [sup]2 = 0.5; P = 0.5). Body dysmorphic delusions (females: 4 [1.8%] vs. males: 20 [8.5%]; ? [sup]2 = 9.6, P 0.5). Family history of schizophrenia was significantly more in females (females: 11.4% vs. males: 5.9%; ? [sup]2 = 3.9, P

Risk factors for stalking violence, persistence, and recurrence

This study used a retrospective design to investigate risk factors associated with violence during a stalking episode, persistence (increased duration of stalking) and recurrence (multiple subsequent separate stalking episodes) in 157 people (91% male, mean age 35 years) with an established history of stalking behaviour. Results showed that diverse risk factors are associated with different types of stalking outcomes. Consistent with previous research, stalking violence was more likely to occur when the victim was an ex-intimate, when explicit threats had been made and where there had been previous property damage (AUC = .74). Personality disorder, older age, criminal versatility, a prior acquaintanceship and erotomanic delusions (AUC = .75) predicted stalking recurrence. Finally, previous acquaintanceship, the presence of delusional beliefs and the absence of a history of physical or sexual violence were associated with stalking persistence. These results clearly show that effective assessment and management of stalking requires consideration of different stalking outcomes and the diversity of associated risk factors.

Erotomania and mood disorder: A case report and literature review

IntroductionErotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the “passionate psychosis”, as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders.ObjectivesTo describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders.MethodsLiterature review and a case report.ResultsWe report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed. After reviewing the literature we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially bipolar affective disorder and major depression, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder: from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link.ConclusionIn clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Erotomania and Recommendations for Treatment

The aim of this paper is to help clinicians better understand how erotomania originates in order to facilitate treatment and make it more effective. Data sources are the narratives of six women who spoke in detail about the beginnings of their delusional beliefs and about the nature of the evidence that convinced them that their beliefs were well-founded. In every case, low self-esteem and emotional arousal preceded the emergence of the delusion. Misperceptions and misattributions appeared responsible for keeping the delusion alive. Despite external disconfirmation, social isolation protected the delusional beliefs from revision and extinction. The erotomanic delusion provided a sense of well-being that probably contributed to its maintenance. As well, a delusion-induced boost in well-being delayed help-seeking. Recommendations for treatment include staged interventions, first establishing a therapeutic alliance with a focus on understanding the psychological factors contributing to the origin and maintenance of the delusion. The next stage is the provision of social support and strategies directed at the restoration of self-esteem. The third stage is the gradual introduction of techniques to correct cognitive biases. Medication and risk management form an integral part of overall management. Objective evidence for the effectiveness of this approach is, however, not yet available.

Erotomania and Mood Disorder : a Case Report and Literature Review

Introduction Erotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the ‘passionate psychosis', as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders. Objectives To describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders. Methods Literature review and a case report Results We report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed. After reviewing the literature, we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially major depression and bipolar affective disorder, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder : from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link. Conclusion In clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.

Opiates and Psychosis: a Case of Psychosis After Methadone Withdrawal

Introduction Opioids modulate dopaminergic transmission in the pathophysiology of psychosis. Methadone, a pure agonist opioid synthetic contains a slightly higher potency, a longer lasting duration and reduced euphoric effect. Opiates may contain beneficial effects on psychosis. We report a case of psychosis after a complete opiate withdrawal. Objectives To describe the possible antipsychotic effects of methadone on a patient who displays psychotic symptoms following the cessation of this treatment. Methods X is a 35 year old female ex-heroin addict who came into the psychiatry emergency because of a psychomotor agitation episode. The patient reported delusions and impaired sensory perception with a behavioural change coincided with the cessation of methadone treatment. Results During admission, the patient’s condition consisted of injuries and erotomanic delusions partial structure. Furthermore, there were delusional interpretations of the environment and the presence of auditory and kinesthetich hallucinations. Behaviour was disorganised and affective blunting dominated. Neuroleptic treatment was prescribed and psychotic symptoms improved progressively. Conclusions Opiate use in patients with psychosis has been linked to a reduction of psychotic symptoms and worsening in periods of abstinence. The caring of these patients should take into account these potential side effects, noting caution in times of detoxification or dose reduction that may exacerbate psychotic symptoms. Although the efficacy of methadone for the treatment of opioid dependence has been demonstrated, there remains insufficient specific scientific evidence in patients with schizophrenia and dual diagnosis. Therefore, it’s recommended that further research into this field of study is both required and necessary.

Gaëtan Gatian de Clérambault (1872–1934) II. Son héritage psychiatrique

The name of G. de Clerambault is nowadays used to designate two distinct psychiatric syndromes: in France and in Russia, the “mental automatism”; in USA and Great Britain, the erotomanic delusion. The mental automatism becomes Clerambault's syndrome at the congress of French alienists of Blois (1927), by the proposition of Angelo Hesnard. The denomination is adopted by Eugen Minkowski in 1933, whereas Clerambault is still alive. The “great automatism” includes the “first rank symptoms” of the schizophrenia described by Kurt Schneider (1939). The symptoms of the “little automatism” are near from the schizophrenic thought disorders of Bleuler (De Morsier, 1929; Heuyer, 1950). Better than the theory of John Hughlings Jackson, they foreshadow the dichotomy between positive and negative symptoms in the schizophrenia (Berrios). The divergences with the “organo-dynamic” theory of Henri Claude and of his pupil Henri Ey (1934, 1948) are more about the psychopathology of the hallucinations, in relation to the delusion, than about the organic origin of the syndrome. “Pure” erotomanic delusion is discussed by Capgras (1923) and then by the pupils of Henri Claude (Lacan, 1932, Ferdière, 1937). It is named Clerambault's syndrome 20years later in the American textbooks of psychiatry (Arieti, 1959; Lehman, 1967). Its comorbidity with several other psychiatric disorders is described in many papers. An “erotomanic type” of the delusional disorder is isolated in the DSM-III-R. After their quarrel of 193l, Jacques Lacan makes a “return to Clerambault” in the years following the 2nd World War and presents him as his “only master in psychiatry” (1966). Many influential French psychiatrists (Guiraud, Heuyer, Daumezon, Baruk, Sivadon) present him as a pionneer. At the end of the 20th century, a biography and a film are exclusively devoted to him.

A romantic delusion: de Clerambault's syndrome in dementia

Erotromania (also known as de Clerambault's syndrome) is a rare disorder in which an individual has a delusional belief that a person of a socially higher standing falls in love with her/him. It has rarely been described in older people, but many cases have been reported in conjunction with psychiatric and neurological disorders. The purpose of this paper was to examine the phenomenon of erotomania in people with dementia. We carried out a search of electronic databases for literature on this subject. The search terms used were: erotomania, de Clerambault's syndrome, erotomanic delusion and dementia. The literature on erotomania in the course of dementia consists mostly of case reports and small samples of patients. Misinterpretation of events is common in brain disease, especially with diffuse or multifocal disorders, but erotomania has rarely been reported in dementia. The relationship between dementia and de Clerambault's syndrome remains uncertain. Erotic delusion arising late in life should be thoroughly investigated to rule out organicity.

Shared psychotic disorder: a case report

Shared psychotic disorder: a case report Shared psychotic disorder (folie a deux) is a rare disorder characterized by delusions and demonstrates intercultural differences. Cases reported in the literature have considerable persecution, reference and mystical delusions. However, erotomanic delusion has been rarely reported. In the present paper, we present a case, the daughter of a schizophrenic mother who has shared psychotic disorder accompanied

Multiple Sclerosis Presenting With Erotomanic Delusions in the Context of “Don't Ask, Don't Tell”

A female patient presented with erotomanic delusions of other female soldiers sexually harassing her and plotting to sexually assault her. On MRI, the patient was found to have numerous periventricular foci of signal changes extending into the deep white matter of both hemispheres. The MRI findings, along with lumbar puncture findings of oligoclonal bands in the cerebral spinal fluid, were consistent with a diagnosis of multiple sclerosis. After treatment with aripiprazole acutely and interferon beta-1a for several months, the patient experienced a decrease in her psychosis. The discussion of this case includes a brief overview of psychosis as a presenting symptom of multiple sclerosis, and also includes consideration of the patient's initial reluctance to seek treatment in light of the policy known colloquially as "don't ask, don't tell".