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Delusions May Not Always Be Delusions

Guest editorial about Morgellons disease versus Delusions of Parasitosis in July 2010 Archives of Psychiatric Nursing

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Virginia Savely DNP
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1K views2 pages

Delusions May Not Always Be Delusions

Guest editorial about Morgellons disease versus Delusions of Parasitosis in July 2010 Archives of Psychiatric Nursing

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Virginia Savely DNP
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© Attribution Non-Commercial (BY-NC)
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This article appeared in a journal published by Elsevier.

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Author's personal copy

ARCHIVES OF

PSYCHIATRIC
NURSING
Vol. 24 No. 4 August 2010

GUEST EDITORIAL

Delusions May Not Always Be Delusions

T he history of medicine is replete with exam-


ples of diseases that have been misdiagnosed
as psychosocial problems. Gastric ulcer patients
black specks, and seed-like objects coming out of the
skin. Because the etiology of the disease is unknown,
diagnosis is based on the patient reporting the charac-
were told that their inability to handle stress was the teristic symptoms and the in-office, microscopic visua-
cause of their disease; epileptics were believed to be lization of fibers under and extruding from the skin.
possessed by the devil; heart disease was blamed on a The first step to unlocking the medical mystery
Type A personality; and patients with tertiary syphilis of Morgellons disease is for the medical community
were placed in straight jackets in insane asylums. to recognize it as a real, somatic condition. When
The philosopher Thomas Kuhn proposed that patients present with unusual symptoms, it is unjust
scientific communities operate within a rigid set of to summarily discount them and confer a stigma-
assumptions and, therefore, are not open to a para- tizing psychiatric diagnosis without a thorough and
digm shift when confronted by an anomaly. Through- proper history and examination. If health care
out history, the medical community has been providers would take the time and effort to really
reluctant to adopt new paradigms or concepts of look at Morgellons patients' skin with illuminated
disease. A case in point is the newly emerging, magnification, they would be amazed and con-
mysterious skin condition with improbable-sounding founded by the unusual phenomena they would see.
symptoms known as Morgellons disease. Its victims Sir William Osler, one of the greatest physicians
are being routinely diagnosed with delusions of and humanitarians of the 19th century, taught that
parasitosis, a rare condition wherein patients mistak- “medicine is learned by the bedside and not in the
enly believe they are infested with parasites. classroom.” We must strive to look beyond what we
Delusions of parasitosis should be re-examined as have been taught when confronted with new and
a valid psychiatric phenomenon. Its victims have no puzzling symptoms. Rather than prejudicially pigeon-
prior history of psychiatric disorders, the onset often holing patients with a psychiatric diagnosis, we owe it
follows an immune suppressing event, it occurs in to them to take their symptoms seriously and
children and in entire families, it is more prevalent in investigate the cause of their distress. The recognition
certain parts of the country, and its onset is seasonal. of Morgellons disease will serve as a reminder to the
Furthermore, it appears to be increasing in inci- medical community that there is much to learn by
dence. One would suspect an infection rather than a taking the time to listen to the patient with open ears
psychosis with this epidemiological picture. and an open mind.
The few medical professionals who are interested in
Morgellons disease are increasingly convinced that its Virginia Savely
victims have been hastily misdiagnosed as delusional E-mail address: Lymesf@gmail.com
when they are in fact suffering from a horrific and http://www.gingersavely.com
puzzling somatic illness. The top symptoms of
Morgellons patients are: spontaneously-appearing,
© 2010 Elsevier Inc. All rights reserved.
slow-healing, open lesions; sensations of crawling, 0883-9417/1801-0005$34.00/0
biting, and stinging on and under the skin; and fibers, doi:10.1016/j.apnu.2010.04.006

Archives of Psychiatric Nursing, Vol. 24, No. 4 (August), 2010: 215 215

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