Flea and tick phobia? Delusional parasitosis in veterinary medicine
Yeah, it’s true. Most people have a built-in fear of bugs. For some unlucky souls, however, the fear is far greater than what most of us would consider rational. A significant percentage of the population is afflicted with this problem. Indeed, it’s common enough for the psychiatric community to have come up with a medical term for it: “delusional parasitosis.”
Yesterday’s post on bedbugs obliquely referenced this concept when I wondered how many of us might stress over bugs based on the prevalence of hyped news reports. After all, we’re only human—and our human instincts are hard-wired to reject bugs at a primal level. Delusional parasitosis takes this basic aversion and amplifies it to impressive proportions of clinical significance…to our pets.
In my almost-thirteen years in practice I’ve only seen a handful of cases where my clients clearly suffered this condition. But these were spectacular circumstances in which my clients pointed at unseen spots on their own skin and compared them to their pets,’ or when invisible crawling parasites caused my clients to writhe freakishly in my presence. One client even swore there was a live creature squirming inside his dog.
You might assume these are examples of people whose meds require some serious adjustment. And you might be right. But to some extent we can all identify with delusional parasitosis.
I know few vets and techs who wouldn’t admit to feeling the creepy-crawlies when examining a seriously mangy dog or fur mite infested cat. Observing the bugs under a microscope does nothing to dispel the inexplicable itchiness we feel at the nape of our necks or the backs of our hands. Viewed in that light, delusional parasitosis is completely comprehensible.
Problem is, most cases of delusional parasitosis fly under the radar. They’re not so radical or obvious as in my previous client examples. In fact, they’re far more akin to our own understandable wrigglings at the sight of bugs in our midst.
How about the owner who swears his dog’s flea meds aren’t working (yet there are no fleas in sight)? Or the one who claims her cat won’t stop scratching (though there’s no evidence of this on her skin)?
Much like Munchausen’s-by-proxy, this lower-level psychological condition in humans can lead vets to prescribe medications we’d never otherwise choose for our patients. “Above all do no harm” may yet be our mantra in medicine, but we’d be duped into pushing its ethical boundaries on the delusional observations of our well intentioned (if somewhat impaired) clients.
How prevalent is delusional parasitosis? That’s debatable. Considering its myriad manifeststions—ranging from the meth-addict’s incessant scratching to this vet’s irrational, ringworm-induced itchiness—could it be that we’re over-prescribing?
It’s worth thinking about.