Delusory Parasitosis and Other Mind Myths About ? Delusory Parasitosis and Other Mind Myths About

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  • Delusory Parasitosis and

    Other Mind Myths About

    Bugs

    Nancy C. Hinkle, Ph.D.

    Dept. of Entomology

    Univ. of Georgia

    Athens, Georgia

  • Morgellons Research Foundation Researching an emerging infectious skin disease

    Image 1: Lip of 3 year old boy, 10x

    Image 2: Object from same lip, 60x

    http://www.morgellons.org/Media.htmlhttp://www.morgellons.org/pics.htmlhttp://www.morgellons.org/register.htmlhttp://www.morgellons.org/Microscopes.htmlhttp://www.morgellons.org/Perspectives.htmlhttp://www.morgellons.org/kellett.htmlhttp://www.morgellons.org/Media.htmlhttp://www.morgellons.org/pics.htmlhttp://www.morgellons.org/register.htmlhttp://www.morgellons.org/Microscopes.htmlhttp://www.morgellons.org/Perspectives.htmlhttp://www.morgellons.org/kellett.html

  • THE FIBER DISEASE

  • CDC Investigating Morgellons Illness CDC investigates whether bizarre Morgellons condition is real or imagined CDC Funds Morgellons Study

    (AP) Imagine your body pocked by erupting sores. The sensation of little

    bugs crawling all over you. And worst of all, mysterious red and blue fibers

    sprouting from your skin.

    It may sound like a macabre science fiction movie, but a growing legion of

    Americans say they suffer from this condition. And now the U.S. Centers

    for Disease Control and Prevention is investigating.

    Some doctors dismiss these patients as delusional. But the condition -

    called Morgellons - has caused a small frenzy on the Internet, with

    hundreds of people pleading for help.

    "Sometimes the government doesn't want to panic people until they can

    figure out a definitive cause," said Pat Boddie, a 62-year-old Alabama

    woman who said she's had Morgellons for 14 years.

    "They're trying to figure out if this is going to be an epidemic. I hate to tell

    them, but it already is," she said.

    The CDC has been receiving as many as 20 calls a day from self-

    diagnosed Morgellons patients. The agency has been urged to investigate

    by, among others, U.S. Sen. Dianne Feinstein of California.

    "We're going into this with an open mind," said Dan Rutz, spokesman for a

    CDC Morgellons task force.

  • EKBOM SYNDROME

    -- A CONDITION IN

    WHICH THE

    INDIVIDUAL

    CONSIDERS

    HIMSELF

    INFESTED BY

    INVISIBLE BUGS

    (DELUSORY PARASITOSIS)

  • Infestation population of

    organisms lives in (or on), feeding,

    reproducing, and sustaining itself

  • Delusory Parasitosis

    Ekbom Syndrome

    an erroneous, unshakable belief that the

    skin is infested with a parasite

    A delusion is a false belief that is not consistent

    with the patients intelligence, educational level,

    or cultural background, and that cannot be

    corrected by reasoning (Koblenzer 1993)

  • EKBOM SYNDROME

    K.A. EKBOM (1907-1977)

    Swedish neurologist who described

    Delusion of Infestation in the

    Elderly

    Acta Psychiatrica et Neurologica Scandinavica (1938)

    History of Psychiatry (Classic Text No. 54) 14(2): 232-256

  • Demographics

    Symptoms

    Management Behaviors

    Medical History

    Comorbidities

  • Dr. Hinkle-

    I have been suffering from what feels like insect bites at night, but

    can't ever see any insects where affected. Every so often I think i

    see something flying past me but have still never found one. I

    used a fogger for my apartment and while it seemed to work for a

    few days, the culprit is back in full force. I also just recently

    returned from being out of town for 4 days thinking the lack of a

    blood source would starve whatever it is, but only seemed to make

    them hungrier.

    I feel like they are crawling on me, followed by an intense sting /

    bite, then a little welt forms that when scratched turns into a scab

    that doesn't heal quickly, as in 1-2 weeks before they finally go

    away (the scabs). Nothing I've found on the web has been helpful

    in pinpointing what I'm dealing with, and I was hoping you might

    be able to steer me in the right direction for relief.

  • Help!!

    I am being bitten alive by invisible bugs! When I'm being bitten I feel a

    sharp sensation, like a tiny pinprick, but when I look at where I am being

    bitten I cant see a darn thing. I have tiny red dots all over my body under

    my skin (where I believe the bugs have bitten me), but my doctor says

    they are probably nothing. (Whatever, doc) There is no welt or noticeable

    bite mark. I feel itchy all over my body, my feet, my belly, my hair,

    especially when I am in the basement and at night. I know this isn't in my

    head b/c when ppl come over to the basement, they are itchy too. Also, I

    believe its a bug that jumps because when I am around someone else,

    they start to feel itchy as well (without me saying a WORD about the

    bugs). I have sprayed the place enough times, vaccuumed and scrubbed

    for hours, washed my sheets and clothes in hot water twice and bagged

    them, then froze them, and have now just resorted to spraying OFF on

    myself and when I'm really desperate - RAID - before and after bed

    because this is the only way I get relief.

    Does anyone battle this same mysterious bug? Any advice????

    Please HELP!

  • PEOPLE BLAME

    SPIDER BITES

    BED BUGS

    SCABIES

    CHIGGERS

    THRIPS

    SPRINGTAILS

    BIRD OR RODENT MITES

  • SPIDERS DO NOT BITE HUMANS

  • BED BUGS ARE NOT INVISIBLE

  • Scabies = Sarcoptes scabiei infestation

  • CHIGGER

  • BITING MIDGE

  • THRIPS

    (THYSANOPTERA)

  • Springtails

    (Collembola)

  • BIRD MITES (FEED ONLY ON BIRDS)

  • Some DP Background:

    DP is the most commonly

    reported delusional disorder

    More than 250,000 cases in U.S.

    Often affects people in pairs

    or groups in a shared

    delusion, called folie-a-deux.

    Entire families, entire offices, are susceptible

  • A. MOST COMMON IN ELDERLY

    B. DISPROPORTIONATELY FEMALE

    C. EXHIBIT SELF-DESTRUCTIVE BEHAVIORS

    1. QUIT JOBS

    2. BURN/DESTROY FURNITURE

    3. ABANDON HOME

    4. OBSESSIVE LAUDERING/CLEANING

    5. REPEATED PESTICIDE MISUSE

    6. USE HOME REMEDIES

    7. SELF-MUTILATION/EXCORIATION

    D. PROVIDE SPECIMENS- GOBBETS OF TISSUE, OTHER

    DEBRIS

    E. ELABORATE DESCRIPTIONS OF PEST & LIFE CYCLE

  • F. SOCIAL ISOLATION

    G. MAJOR LIFE EVENT (DIVORCE, BEREAVEMENT,

    JOB LOSS)

    H. CONSULTED SEVERAL PHYSICIANS

    I. MEAN DURATION OF DELUSION > 3 YR.

    J. COMPLAIN OF ITCHING, CRAWLING, STINGING,

    BITING

    K. ADAMANT THAT IT IS AN INFESTATION

    L. EXPRESSES DESPERATION

    M. DELUSION EVENTUALLY SHARED BY ANOTHER

  • When the sensation is felt

    Apply tape

    Gently fold tape on itself

    Box and ship

  • SENSATIONS ARE REAL

    PHYSICAL

    PHYSIOLOGICAL

    PSYCHOLOGICAL

  • PHYSICAL CAUSES OF

    SKIN DISCOMFORT

  • PHYSIOLOGICAL CAUSES OF SKIN DISCOMFORT

    DERMATOGRAPHIA

    (DERMNET.COM)

    RINGWORM

  • DIABETIC NEUROPATHY IS A SERIOUS COMPLICATION OF

    DIABETES, AFFECTING HALF OF DIABETICS.

    NERVES DAMAGED BY DIABETIC NEUROPATHY CAN CAUSE

    STINGING OR BURNING SENSATIONS, TINGLING, PAIN,

    NUMBNESS OR A CRAWLING SENSATION ON THE SKIN.

  • FORMICATION

  • SOME DISEASES CHARACTERIZED

    BY PARESTHESIA OR PRURITUS

    SYMPTOMS

    AUTOIMMUNE DISEASES (LUPUS)

    CARDIOVASCULAR DISEASE

    CIRRHOSIS

    DIABETES

    HEPATITIS

    HIV INFECTION

    HODGKINS DISEASE

    HYPERTHYROIDISM

    HYPOTHYROIDISM

    HEAVY-METAL POISONING

    LYME DISEASE

    MALIGNANCIES/NEOPLASMS

    MULTIPLE SCLEROSIS

    PARKINSONS DISEASE

    RENAL FAILURE

    STROKE

    SYPHILIS

    VITAMIN DEFICIENCIES

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    DRUG

    POSSIBLE SIDE EFFECTS

    1

    Rash, paresthesia, pruritus

    2

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    3

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    4

    Paresthesia, pruritus, rash, urticaria, erythema

    5

    Erythema, rash, urticaria

    6

    Erythema, rash

    7

    Dermatitis, pruritus, paresthesia, rash, urticaria

    8

    Paresthesia, dermatitis, pruritus, rash, urticaria

    9

    Paresthesia, pruritus, rash

    10

    Paresthesia, pruritus, urticaria

    Top 10 U.S. Prescription Products by Sales, 2008

    Lipitor

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    Lisinopril

    Lotensin

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    Xanax

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  • COCAINE BUGS AND METH MITES

  • COCAINE BUGS

    AND

    METH MITES

    COCAINE

  • The patient

    complained of a

    worm infestation in

    his neck. He used a

    pair of scissors to

    excise the imagined

    worms.

    The toxicology screening of this patient was

    positive for cocaine, opiates, and tranquilizers.

  • STRESS

    ANXIETY

    DEPRESSION

    PSYCHOLOGICAL CAUSES

  • DISPLACEMENT ACTIVITY

    an unconscious defense mechanism whereby the

    mind redirects from situations producing

    internal conflict (uncertainty or anxiety) and felt

    to be dangerous or unacceptable to a focus felt to

    be safe or acceptable.

    Scratching and autogrooming (picking) are the

    most commonly reported displacement activities

    among primates.

  • FIRST

    IDENTIFY THE PEST

  • What does your

    agreement to treat

    obligate you to?

  • THEY ARE STRICTLY MEDICAL CONDITIONS.

    THE ONLY ARTHROPODS THAT INFEST HUMAN

    BODIES ARE SCABIES MITES AND HUMAN LICE.

    BECAUSE THESE LIVE EXCLUSIVELY ON

    HUMAN BODIES, THERE IS NO ROLE FOR A PMP

    IN CONTROLLING THEM.

    SCABIES MITE

    HUMAN LOUSE

  • No insect or mite can live in the environment and

    switch to infesting the human body.

    No insect or mite can feed on inorganic materials, so

    cannot survive on furniture or carpeting.

    No winged insects infest human bodies.

    No invisible mites or insects infest human bodies.

    No external animal parasites can infest humans.

    Bird mites cannot infest humans.

    Human body infestation is a medical condition and

    must be treated by a physician.

  • EKBOM SYNDROME IS A MEDICAL CONDITION

    Refer cases to UGA (Insects@uga.edu) 706-542-9033

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