- Delusional Jealousy (Othello Syndrome) in 67 Patients with Parkinson's Disease. [Review]
- FNFront Neurol 2018; 9:129
- Othello syndrome (OS) is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. Because OS has infrequently occurred in patients with Pa…
Othello syndrome (OS) is a type of paranoid delusional jealousy, characterized by the false absolute certainty of the infidelity of a partner. Because OS has infrequently occurred in patients with Parkinson's disease (PD), the characteristics of OS in PD remain unclear. We reviewed the clinical characteristics of this syndrome in PD. We reviewed 67 patients who had PD with OS. OS was more common in men (45 patients) than in women (22 patients), and it frequently occurred in middle-aged patients. Until the onset of OS, the duration of PD (range, 2-19.8 years) and the duration of treatment with PD medications (range, 2 months to 18.5 years) varied. At the onset of OS, cognition was preserved in most patients. 42 of 47 patients had other psychiatric disorders in addition to OS, and 5 patients had isolated OS. Persecutory or other paranoid delusions developed in 34 patients with OS. OS was associated with PD medication in 25 of 26 patients, especially in patients, used the dopamine agonists. The dose of the PD medication associated with OS was decreased or these drugs were withdrawn to facilitate the treatment of OS. In most patients, OS disappeared or the severity of OS was reduced. OS is infrequent in patients with PD, but is likely to be easily detected because OS is commonly accompanied by persistent paranoid and sexual delusions. When clinicians encounter such patients, the withdrawal or reduction of dopamine agonists should be attempted, and if necessary, additional treatment with clozapine is recommended.
- Pharmacotherapy for primary delusional jealousy, a retrospective observational study of 32 cases with Othello syndrome. [Journal Article]
- ICInt Clin Psychopharmacol 2018; 33(2):92-97
- To determine whether primary delusional jealousy can be treated effectively with antipsychotics or antidepressants, and whether any clinical variables are associated with response to pharmacotherapy,…
To determine whether primary delusional jealousy can be treated effectively with antipsychotics or antidepressants, and whether any clinical variables are associated with response to pharmacotherapy, we carried out a retrospective case series observational study by reviewing clinical records of patients with an International Classification of Disease, 9th ed., diagnostic code of 297 (delusional disorders) who were treated at the Department of Psychiatry of a university affiliated hospital from January 2010 to December 2015. Only those records showing obvious delusional jealousy not secondary to other medical conditions, dementia, or schizophrenia were scrutinized thoroughly with respect to types of pharmacotherapy, treatment response, and other demographic and clinical variables likely to be associated with clinical outcomes. All except one of 32 patients, 16 men and 16 women, between 37 and 79 (60.9±10.6) years of age, were treated with low-dose antipsychotics. The general response was favorable as 19 (59.4%) were rated as good and 13 as inadequate responders (seven partial and six limited). Compared with antipsychotic monotherapy, concomitant therapy with antidepressants had a higher rate of good response, although statistically insignificant (75 vs. 53%, P=0.21). Younger age (P=0.01) and presentation at the index visit with their suspected unfaithful spouse were associated with a good response (P=0.036); comorbidity with delusions other than the jealous type was associated with a poor response (P=0.006). The overall outcome for delusional jealousy looks promising if the patients can accept pharmacotherapy in an outpatient setting.
- De Clérambault Syndrome, Othello Syndrome, Folie à Deux and Variants. [Review]
- FNFront Neurol Neurosci 2018; 42:44-50
- Non-bizarre delusion, defined as a false belief possible although highly unlikely, is the main manifestation of delusional disorders, previously known as paranoia. Based on the predominant delusional…
Non-bizarre delusion, defined as a false belief possible although highly unlikely, is the main manifestation of delusional disorders, previously known as paranoia. Based on the predominant delusional themes, 5 main subtypes may be described - erotomanic, grandiose, jealous, persecutory, and somatic. We present here 2 main delusional disorders, the De Clérambault syndrome and the Othello syndrome, and another closely related to the previous ones - Folie à deux. In the De Clérambault syndrome, the main delusional theme is erotomanic type, related to passional delirium where the patient has strong sexual feelings towards another person and has the belief that this other person is deeply in love with him or her. Patients with the Othello syndrome present a delusional disorder of jealous type, a pathological delusion that the partner is unfaithful. In Folie à deux, 2 individuals shared the same psychiatric symptom. However it may be variable, describing variants such as folie imposée or folie simultenée. The risk of aggressive behavior exists in these patients. Knowledge of these syndromes is essential to allow an accurate diagnosis and prompt treatment.
- The neuropsychological profile of Othello syndrome in Parkinson's disease. [Case Reports]
- CCortex 2017; 96:158-160
- [The Othello syndrome in Parkinson's disease: an example of a lesser-known delusion]. [Case Reports]
- TPTijdschr Psychiatr 2017; 59(5):302-305
- Delusions are fairly common features of Parkinson's disease. Some delusions are easily recognised, but others are less well-known and can be missed by health professionals. We describe the case of a …
Delusions are fairly common features of Parkinson's disease. Some delusions are easily recognised, but others are less well-known and can be missed by health professionals. We describe the case of a female patient with Parkinson's disease who believed, erroneously, that her partner was being unfaithful; this type of delusion is also called the Othello syndrome. After psychoeducation and the start of clozapine, the delusion faded and the relationship became more peaceful.
- Pathological Jealousy: An Interactive Condition. [Review]
- PPsychiatry 2016; 79(4):379-388
- CONCLUSIONS: Treatment effectiveness does not yet have a firm evidence base.
- Delayed-onset Othello syndrome after stroke with lesions in the cerebellar-pontine area? [Case Reports]
- ANAust N Z J Psychiatry 2017; 51(4):416-417
- Dopamine dysregulation syndrome and psychosis in 24-h intestinal levodopa infusion for Parkinson's disease. [Letter]
- PRParkinsonism Relat Disord 2016; 31:144-145
- Othello syndrome after STN DBS - psychiatric side-effects of DBS and methods of dealing with them. [Case Reports]
- PPPsychiatr Pol 2016; 50(2):323-327
- CONCLUSIONS: In recent years, work is underway on the use of DBS in psychiatry, particularly in patients with treatment-resistant depression. It is necessary to set the strategy for dealing with side-effects of DBS. Most of the authors prefer the temporary or permanent switch off the stimulator. In the author's opinion, in some cases it is possible to effectively treat the psychotic symptoms without resignation from the benefits of stimulation. So far, however, such cases were described so rarely that it is difficult on this basis to formulate conclusions that can be applied to the whole population of patients treated with DBS. Only a systematic study including an assessment of psychotic symptoms using scales and analysing the received treatment and stimulation parameters could give an idea of what is the most appropriate strategy in case of psychosis following DBS.
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- Koro, Othello and Capgras syndromes in one patient with drug induced psychosis. [Case Reports]
- PDPsychiatr Danub 2015; 27(4):429-30