Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Dec 10;12(12):CD011326.
doi: 10.1002/14651858.CD011326.pub2.

Treatments for primary delusional infestation

Iyas Assalman  1 , Alia Ahmed  2 , Randa Alhajjar  3 , Anthony P Bewley  4 , Ruth Taylor  5
Affiliations
Meta-Analysis

Treatments for primary delusional infestation

Iyas Assalman et al. Cochrane Database Syst Rev. .

Abstract

Background: Primary delusional infestation (DI) is a primary psychiatric disorder characterised by delusions and abnormal tactile sensations. The pathophysiology is undecided and treatment includes both pharmacological and non-pharmacological options. There is currently no Cochrane Review of the treatments used. Primary DI is a diagnosis often encountered by both dermatologists and psychiatrists, with a large associated disease burden.

Objectives: To evaluate the effectiveness of different treatments in primary delusional infestation (DI).

Search methods: On 24 December 2014 and 19 March 2019, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials including registries of clinical trials.

Selection criteria: Randomised controlled trials involving the treatment of adults with primary DI.

Data collection and analysis: Two review authors independently screened and assessed studies for inclusion using pre-specified inclusion criteria.

Main results: We did not identify any studies for inclusion.

Authors' conclusions: Currently there is no evidence from RCTs available to compare treatment of primary DI with placebo. We cannot, therefore, make any conclusions regarding the effects of treatments (pharmacological or non-pharmacological) for primary DI. This lack of evidence for treatment of primary DI has implications for research and practice. Robust randomised trials are indicated.

PubMed Disclaimer

Conflict of interest statement

Iyas Assalman: no conflicts of interest directly related to this review. He has attended conferences organised and funded by pharmaceutical companies: (i) Changing Faces, 30 & 31 January 2012 organised by Lundbeck; and (ii) IMPACT Paris: "Laying the Foundation for Recovery in Mental Illness", 19‒21 March 2010 organised by Otsuka Pharmaceuticals.

Anthony P Bewley: none

Randa Alhajjar: none

Alia Ahmed: none

Ruth Taylor: none

Figures

1
1
Study flow diagram.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD011326

References

Additional references

Ahmed 2013
    1. Ahmed A, Bewley A. Delusional infestation and patient adherence to treatment: an observational study. British Journal of Dermatology 2013;169(3):607‐10. - PubMed
Altman 1996
    1. Altman DG, Bland JM. Detecting skewness from summary information. BMJ 1996;313(7066):1200. - PMC - PubMed
Bailey 2014
    1. Bailey CH, Andersen LK, Lowe GC, Pittelkow MR, Bostwick JM, Davis MDP. A population‐based study of the incidenceof delusional infestation in Olmsted County, Minnesota, 1976‐2010. British Journal of Dermatology 2014;170(5):1130‐5. - PMC - PubMed
Berrios 1985
    1. Berrios GE. Delusional parasitosis and physical disease. Comprehensive Psychiatry 1985;26(5):395‐403. - PubMed
Bewley 2010
    1. Bewley AP, Lepping P, Freudenmann RW, Taylor R. Delusional parasitosis: time to call it delusional infestation. British Journal of Dermatology 2010;163(1):1‐2. - PubMed
Bland 1997
    1. Bland JM. Statistics notes. Trials randomised in clusters. BMJ 1997;315(7108):600. - PMC - PubMed
Boissel 1999
    1. Boissel JP, Cucherat M, Li W, Chatellier G, Gueyffier F, Buyse M, et al. The problem of therapeutic efficacy indices. 3. Comparison of the indices and their use [Aperçu sur la problématique des indices d'efficacité thérapeutique, 3: comparaison des indices et utilisation. Groupe d'Etude des Indices D'efficacite]. Therapie 1999;54(4):405‐11. [PUBMED: 10667106] - PubMed
Cipriani 2009
    1. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, et al. Comparative efficacy and acceptability of 12 new‐generation antidepressants: a multiple‐treatments meta‐analysis. Lancet 2009;373(9665):746‐58. - PubMed
Deeks 2000
    1. Deeks J. Issues in the selection for meta‐analyses of binary data. Proceedings of the 8th International Cochrane Colloquium; 2000 Oct 25‐28; Cape Town. Cape Town: The Cochrane Collaboration, 2000.
Deeks 2011
    1. Deeks JJ, Higgins JP, Altman DG. Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JP, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Divine 1992
    1. Divine GW, Brown JT, Frazier LM. The unit of analysis error in studies about physicians' patient care behavior. Journal of General Internal Medicine 1992;7(6):623‐9. - PubMed
Donner 2002
    1. Donner A, Klar N. Issues in the meta‐analysis of cluster randomized trials. Statistics in Medicine 2002;21(19):2971‐80. - PubMed
Eccles 2013
    1. Eccles JA, Garfinkel SN, Taylor RE, Bewley AP, Critchley HD. Imaging abnormal skin sensations: a novel functional MRI study. Lancet 2013;381:S38.
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Elbourne 2002
    1. Elbourne D, Altman DG, Higgins JP, Curtina F, Worthingtond HV, Vaile A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140‐9. - PubMed
Elmer 2000
    1. Elmer KB, George RM, Peterson K. Therapeutic update: use of risperidone for the treatment of monosymptomatic hypochondriacal psychosis. Journal of the American Academy of Dermatology 2000;43:683‐6. - PubMed
Freudenmann 2008
    1. Freudenmann RW, Lepping P. Second‐Generation Antipsychotics in Primary and Secondary Delusional Parasitosis: Outcome and efficacy. Journal of Clinical Psychopharmacology 2008;28:500‐8. - PubMed
Freudenmann 2009
    1. Freudenmann RW, Lepping P. Delusional infestation. Clinical Microbiology Reviews 2009;22(4):690‐732. - PMC - PubMed
Friedmann 2006
    1. Friedmann AC, Ekeowa‐Anderson A, Taylor R, Bewley A. Delusional parasitosis presenting as folie à trois: successful treatment with risperidone. British Journal of Dermatology 2006;155:841‐2. - PubMed
Frithz 1979
    1. Frithz A. Delusions of infestation: treatment by depot injections of neuroleptics. Clinical and Experimental Dermatology 1979;4(4):485‐8. - PubMed
Furukawa 2006
    1. Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta‐analyses can provide accurate results. Journal of Clinical Epidemiology 2006;59(1):7‐10. - PubMed
GRADEpro GDT [Computer program]
    1. McMaster University (developed by Evidence Prime). GRADEpro GDT. Version accessed 6 August 2016. Hamilton (ON): McMaster University (developed by Evidence Prime), 2015.
Gulliford 1999
    1. Gulliford MC. Components of variance and intraclass correlations for the design of community‐based surveys and intervention studies: data from the Health Survey for England 1994. American Journal of Epidemiology 1999;149(9):876‐83. - PubMed
Hamann 1982
    1. Hamann K, Avnstorp C. Delusions of infestation treated by pimozide: a double‐blind crossover clinical study. Acta Dermato‐venereologica 1982;62(1):55‐8. - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Green S. Chapter 7: Selecting studies and collecting data. In: Higgins JP, Green S editor(s), Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Higgins 2017
    1. Higgins JP, Altman DG, Sterne JA, editor(s). Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Churchill R, Chandler J, Cumpston MS, editor(s), Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). The Cochrane Collaboration, 2017. Available from www.training.cochrane.org/handbook.
Hutton 2009
    1. Hutton JL. Number needed to treat and number needed to harm are not the best way to report and assess the results of randomised clinical trials. British Journal of Haematology 2009;146(1):27‐30. [PUBMED: 19438480] - PubMed
Kay 1986
    1. Kay SR, Opler LA, Fiszbein A. Positive and Negative Syndrome Scale (PANSS) Manual. North Tonawanda, NY: Multi‐Health Systems, 1986.
Leon 2006
    1. Leon AC, Mallinckrodt CH, Chuang‐Stein C, Archibald DG, Archer GE, Chartier K. Attrition in randomized controlled clinical trials: methodological issues in psychopharmacology. Biological Psychiatry 2006;59(11):1001‐5. [PUBMED: 16905632] - PubMed
Lepping 2007
    1. Lepping P, Russell I, Freudenmann RW. Antipsychotic treatment of delusional parasitosis: systematic review. British Journal of Psychiatry 2007;191:198‐205. - PubMed
Leucht 2005a
    1. Leucht S, Kane JM, Kissling W, Hamann J, Etschel E, Engel RR. What does the PANSS mean?. Schizophrenia Research 2005;79(2‐3):231‐8. [PUBMED: 15982856] - PubMed
Leucht 2005b
    1. Leucht S, Kane JM, Kissling W, Hamann J, Etschel E, Engel R. Clinical implications of brief psychiatric rating scale scores. British Journal of Psychiatry 2005;187:366‐71. [PUBMED: 16199797] - PubMed
Marshall 2000
    1. Marshall M, Lockwood A, Bradley C, Adams C, Joy C, Fenton M. Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia. British Journal of Psychiatry 2000;176:249‐52. - PubMed
Overall 1962
    1. Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychological Reports 1962;10:799‐812.
Paholpak 1990
    1. Paholpak S. Delusion of parasitosis: a report of ten cases at Srinagarind Hospital. Journal of the Medical Association of Thailand 1990;73(2):111‐4. - PubMed
Partridge 1950
    1. Partridge M. One operation cures three people. Effect of prefrontal leucotomy on a case of folie a deux et demi. Archives of Neurology and Psychiatry 1950;64:792‐6. - PubMed
Review Manager 2014 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Schünemann 2017
    1. Schünemann HJ, Oxman AD, Higgins JP, Vist GE, Glasziou P, Akl E, et al. Chapter 11: Completing ‘Summary of findings’ tables and grading the confidence in or quality of the evidence. In: Higgins JP, Churchill R, Chandler J, Cumpston MS, editor(s), Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). The Cochrane Collaboration, 2017. Available from www.training.cochrane.org/handbook.
Shokraneh 2017
    1. Shokraneh F, Adams CE. Study‐based registers of randomized controlled trials: Starting a systematic review with data extraction or meta‐analysis. BioImpacts 2017;7(4):209‐217. [DOI: 10.15171/bi.2017.25] - DOI - PMC - PubMed
Srinivasan 1994
    1. Srinivasan TN, Suresh TR, Jayaram V, Fernandez MP. Nature and treatment of delusional parasitosis: a different experience in India. International Journal of Dermatology 1994;33:851‐5. - PubMed
Sterne 2011
    1. Sterne JA, Egger M, Moher D. Chapter 10: Addressing reporting biases. In: Higgins JP, Green S editor(s). Cochrane Handbook for Systematic Reviews of Intervention. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Trabert 1991
    1. Trabert W. Epidemiology of ectoparasitic infestation. Nervenarzt 1991;62(3):165‐9. - PubMed
Trabert 1993
    1. Trabert W. Delusional parasitosis. Studies on frequency, classification and prognosis. Dissertation. Universitat des Sarlaandes, Homberg/Saar, Germany 1993.
Trabert 1995
    1. Trabert W. 100 years of delusional parasitosis. Meta‐analysis of 1,223 case reports. Psychopathology 1995;28(5):238‐46. - PubMed
Ukoumunne 1999
    1. Ukoumunne OC, Gulliford MC, Chinn S, Sterne JAC, Burney PGJ. Methods for evaluating area‐wide and organistation‐based intervention in health and health care: a systematic review. Health Technology Assessment 1999;3(5):iii‐92. - PubMed
Ungvári 1986
    1. Ungvári G, Vladár K. Pimozide treatment for delusion of infestation. Activitas Nervosa Superior 1986;28(2):103‐7. - PubMed
Wong 2011
    1. Wong S, Bewley A. Patients with delusional infestation (delusional parasitosis) often require prolonged treatment as recurrence of symptoms after cessation of treatment is common: an observational study. British Journal of Dermatology 2011;165(4):893‐6. - PubMed
Xia 2009
    1. Xia J, Adams CE, Bhagat N, Bhagat V, Bhoopathi P, El‐Sayeh H, et al. Loss to outcomes stakeholder survey: the LOSS study. Psychiatric Bulletin 2009;33(7):254‐7.
Yamashita 1986
    1. Yamashita T. Treatment of delusions of parasitosis: efficacy of transcutaneous electrical stimulation. Seishin Shinkeigaku Zasshi 1986;88:1‐13. - PubMed
Zanol 1998
    1. Zanol K, Slaughter J, Hall R. An approach to the treatment of psychogenic parasitosis. International Journal of Dermatology 1998;37(1):56‐63. - PubMed
Zomer 1998
    1. Zomer SF, Wit RF, Bronswijk JE, Nabarro G, Vloten WA. Delusions of parasitosis. A psychiatric disorder to be treated by dermatologists? An analysis of 33 patients. British Journal of Dermatology 1998;138(6):1030‐2. - PubMed

Publication types

Substances

LinkOut - more resources