8.8 Parasite delusion

Biologists and veterinarians are sometimes asked by patients to give their opinion about "parasites" collected from the patient’s body. These should not be investigated in the presence of the patient. If the "parasites" later on prove merely to be particles of dirt, dried worms, plant lice or similar objects, the patient must be assumed to be suffering from a dermatozoan delusion accompanied by a chronically tactile hallucination. As soon as a psychiatrist has successfully treated the delusion, the hallucinations also disappear.

An argument on the nature of the objects should be avoided; the delusion remains unshakeable. Simulated treatment should also never be attempted because this only strengthens the delusion. The possibility of a serious sickness, which requires treatment by a specialist, must however be declared to the patient but the diagnosis must be kept open. The contradiction of the seriousness of the possible disease without a certain diagnosis should lead the patient to consult a qualified psychiatrist. The fine line between the suspicion of not being taken seriously and strengthening of the delusion might direct the patient to undergo psychiatric treatment for conflict resolution. Often an otherwise healthy patient is faced by a seemingly hopeless situation in their life conditions and these are misinterpreted by the patient as being attributable to "parasites". To distinguish and to treat such a constellation of difficulties needs great sensitivity and experience with regards to patients suffering from delusions.

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