Background:Delusional infestation is a condition at the interface of tactile and visual hallucinations and delusions. Individuals with this condition hold the fixed and false belief that their body or their environment is infested with parasites, insects or other organisms.Aims:There are no guidelines or publications detailing the psychological assessment, formulation, intervention and evaluation of this presentation. This paper aims to address this gap.Method:Single case experimental design methodology was employed to evaluate the use of cognitive behavioural therapy (CBT) for delusional infestation in a 70-year-old male who was intolerant of anti-psychotic medication. ‘Tom’ had a large, mature infarct in the middle cerebral artery territory as well as a left posterior parietal infarct post-stroke, which may have precipitated his symptoms. After a baseline period of 3 weeks, Tom received eight sessions of CBT based on the model by Collerton and Dudley (2004).Results:Post-intervention, there was a reliable improvement on clinical measures as well as a large reduction in distress levels, which was maintained at 3-month follow-up. The conviction in the belief that the infestation was real did not shift.Conclusion:This case demonstrated the potential for the use of CBT to address distress related to delusional infestation. This work is discussed in relation to post-stroke psychosis, psychological therapies with older adults, and suggestions are made for future research.

中文翻译：

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71 岁男性中风后“妄想感染”的简短认知行为疗法：单例实验设计

背景：妄想感染是一种在触觉和视觉幻觉和妄想界面的状态。患有这种疾病的个人持有固定的错误信念，即他们的身体或环境被寄生虫、昆虫或其他生物侵染。目标：没有详细说明本演示文稿的心理评估、制定、干预和评估的指南或出版物。本文旨在解决这一差距。方法：采用单例实验设计方法来评估认知行为疗法（CBT）对抗精神病药物不耐受的70岁男性妄想感染的使用。“汤姆”在大脑中动脉区域有一个大的、成熟的梗塞，以及中风后的左后顶叶梗塞，这可能导致了他的症状。在 3 周的基线期后，Tom 根据 Collerton 和 Dudley (2004) 的模型接受了 8 次 CBT。结果：干预后，临床测量得到了可靠的改善，并且痛苦水平大幅降低，在 3 个月的随访中保持不变。相信感染是真实的信念并没有改变。结论：这个案例证明了使用 CBT 来解决与妄想性感染相关的痛苦的潜力。这项工作与中风后精神病、老年人的心理治疗有关，并为未来的研究提出了建议。在 3 个月的随访中，临床测量得到了可靠的改善，痛苦水平也大幅降低。相信感染是真实的信念并没有改变。结论：这个案例证明了使用 CBT 来解决与妄想性感染相关的痛苦的潜力。这项工作与中风后精神病、老年人的心理治疗有关，并为未来的研究提出了建议。在 3 个月的随访中，临床测量得到了可靠的改善，痛苦水平也大幅降低。相信感染是真实的信念并没有改变。结论：这个案例证明了使用 CBT 来解决与妄想性感染相关的痛苦的潜力。这项工作与中风后精神病、老年人的心理治疗有关，并为未来的研究提出了建议。