背景:妄想侵染,也被称为Ekbom综合征,是一种罕见的妄想症,其特征是固定的信念,即寄生虫感染,蠕虫,昆虫,或其他生物。尽管妄想症是一种精神病,患者经常向皮肤科医生咨询皮肤检查结果,目前尚不清楚这种疾病的推荐治疗方法。
目的:我们旨在系统回顾和描述原发性妄想感染患者的治疗和管理。
方法:使用Ovid在MEDLINE上进行了系统搜索,Embase,PsycINFO,和Cochrane临床试验注册。相关数据,包括治疗,剂量,回应,坚持,和副作用,进行了提取和分析。
结果:共包括15个病例系列,包括280名患者(平均年龄53.3岁,65.4%的女性)患有妄想感染。总的来说,阿立哌唑的完全缓解率最高,为79%(11/14),尽管这仅限于14名患者。在药物类别中,选择性5-羟色胺再摄取抑制剂在共患抑郁症患者中最有效,完全缓解率为79%(11/14),部分缓解率为43%(9/21),焦虑,或者毛滴虫病。第一代抗精神病药和第二代抗精神病药的完全缓解率相似(56/103,54.4%vs56/117,47.9%,分别)和部分缓解率(36/103,35%vs41/117,35%,分别)。
结论:由于妄想症的罕见性,我们只发现了15个系列病例.然而,我们发现,第一代抗精神病药物治疗原发性妄想感染的有效性与第二代抗精神病药物相似.需要更大规模的研究和随机对照试验来评估药物治疗妄想侵染的疗效。
背景:PROSPEROCRD42020198161;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=198161。
BACKGROUND: Delusional infestation, also known as Ekbom syndrome, is a rare delusional disorder characterized by the fixed belief that one is infested with parasites, worms, insects, or other organisms. Although delusional infestation is a psychiatric condition, patients often consult dermatologists with skin findings, and it is currently unclear what treatments are recommended for this disorder.
OBJECTIVE: We aimed to systematically
review and describe the treatment and management of patients presenting with primary delusional infestation.
METHODS: A systematic search was conducted using Ovid on MEDLINE, Embase, PsycINFO, and the Cochrane Register of Clinical Trials. Relevant data, including treatment, dosage, response, adherence, and side effects, were extracted and analyzed.
RESULTS: A total of 15 case series were included, comprising 280 patients (mean age 53.3 years, 65.4% female) with delusional infestation. Overall, aripiprazole had the highest complete remission rate at 79% (11/14), although this was limited to 14 patients. Among drug classes, selective serotonin reuptake inhibitors were the most effective with a 79% (11/14) complete remission rate and 43% (9/21) partial remission rate in patients with comorbid depression, anxiety, or trichotillomania. First-generation antipsychotics and second-generation antipsychotics had similar complete remission rates (56/103, 54.4% vs 56/117, 47.9%, respectively) and partial remission rates (36/103, 35% vs 41/117, 35%, respectively).
CONCLUSIONS: Due to the rarity of delusional infestation, we only found 15 case series. However, we found that first-generation antipsychotics appear to be similar in effectiveness to second-generation antipsychotics for the treatment of primary delusional infestation. Larger studies and randomized controlled trials are needed to evaluate the efficacy of pharmacological therapy for delusional infestation.
BACKGROUND: PROSPERO CRD42020198161; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=198161.