The patient had an involuntary admission to a psychiatric inward due to threats of physical aggression with an axe to his wife in the context of irreducible ideas of her infidelity. He described himself as not very sociable and careful to trust others. He consumed 12 g of alcohol per day and denied (confirmed by his relatives) past or current abuse of substances. Relevant personal medical history included the diagnosis of hypertension, overweight and benign prostatic hyperplasia. Until his first admission to the Psychiatric department, the patient had no psychiatric history. The patient is a 76-year-old man, currently retired and living with his wife. In order to protect confidentiality, we do not reveal information that could easily identify him. The patient consented to the publication of this clinical case. With this clinical case, we explore the difficulties in the pharmacological approach of delusional jealousy disorder and summarize the most recent findings in the treatment of this condition. ( 6 There is a higher prevalence in men, the age of onset is usually middle or late adulthood and there is frequent comorbidity with mood disorders, alcohol abuse and organic brain syndromes. It accounted for 11% of all delusional disorders in a large-scale community sample 5 and 8.1% in a hospital outpatient case series. ![]() Statistics on prevalence are difficult to obtain because these patients rarely seek help from a mental health professional. The available data suggests the role of altered dopaminergic activity in frontostriatal circuits and insula, as well as disturbance of reward processing and self-related processing of feelings of jealousy. ( 2ĭelusional jealousy is a subtype of delusional disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, as well as is in the International Classification of Diseases, 10th Revision. Two factors maintain jealousy: the idea of infidelity (triggered by partner's behaviour) and an individual emotional predisposition linked to personality traits (paranoid, or borderline) or concomitant psychiatric disorder. Delusional jealousy, also known as Othello syndrome, arises intuitively and is fortified by pathological interpretations, fabulations, and altered memories, forming a strong ideo-affective system of jealousy.
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