Morgellon disease – an underreported delusional disorder
Morgellon disease is a delusional disorder often poorly understood and manifests as small fibres or other small particles emerging from the skin. The condition is characterised with the belief that there are parasites or foreign material moving in or coming out of the skin. The name of the condition was coined by Mary Leitao, a mother who rejected the diagnosis of her son’s delusional condition, in 2002.
This article describes the case of Morgellon disease in a 26-year-old athlete who discontinued his active involvement in sports after a contusion to his right knee during a race. The athlete went under a joint surgery and was unable to participate in sports sports after. Doctors advised the patient to use cannabinoid daily. 3 months after the surgery, the patient went to the dermatologist with complaints of skin rashes, intense itching and crawling sensation on and under the skin. He also reported fibres emerging from the skin.
Doctors started the patient on antibiotics, however, despite treatment, his symptoms did not subside.
The dermatologist then initiated treatment with antibiotic creams and corticosteroids. This treatment didn’t work either and the symptoms persisted.
The patient was then referred to a psychiatrist concerning his complaints of increased anxiety, poor concentration and fatigue. Based on his medical history, the psychiatrist diagnosed the patient with Morgellon disease. He was started on treatment with risperidone, an atypical antipsychotic used to treat schizophrenia and bipolar disorder. The patient showed significant improvement in symptoms after a month of the medication.
The disease is known to be associated with psychiatric, nerve and non-specific skin symptoms. Some doctors delineate the condition as delusional and treat it with counselling, antipsychotic drugs, anti-depressants and cognitive behavioural therapy.
What does research say about the disease?
Research conducted over the decades has conflicting views about the condition. Many studies report a possible link between Morgellon and infection with Borrelia spirochetes. However, this is contradicted by an earlier study by Centers for Disease Control and Prevention (CDC), stating that the condition is not causes by an infection or parasites. The study further states that the symptoms are similar to those of a mental illness involving false beliefs of delusional infestation.
There is currently no proven guidance on diagnosis and treatment of Morgellon disease, despite several small researches being conducted.
References
Morgellon disease: A case report https://www.cambridge.org/core/journals/european-psychiatry/article/morgellon-disease-a-case-report/2F89A31B7C66592E7CC1D661BAC6BAB3