In Search of Cupid - Erotomania

According to the Merriam-Webster dictionary, a crush is defined as “a strong feeling of romantic love for someone that is usually not expressed and does not last a long time”. But what happens when a crush goes too far? 

My Phantom Lover by Janet Hetherington

Erotomania or De Clerambault’s sydrome is what we have! Although named after the French psychiatrist, G.G. de Clerambault who first delineated its features in 1942, early descriptions of the syndrome date back to Hippocrates [1].

Erotomania is a rare psychological disorder that is marked by the delusional belief of a person (usually a woman) that a man, typically of higher social, political or economic status, is in love with her [2]. Usually, the woman has had little or no contact with the man and the man is in some way unattainable either because he is married, has no personal interest, or is sometimes even dead.
Two forms of the disorder have been identified so far [2]: Primary erotomania is characterized by delusions unaccompanied by hallucinations. The illness is clearly defined, the onset sudden and the course chronic. These patients are classified into a so-called fixed group where delusions remain unchanged over a period of years. Secondary erotomania on the other hand is usually associated with other psychoses – most commonly paranoid schizophrenia. These patients fall into the recurrent group who are less psychiatrically ill, but have intense delusions that are short lived. Patients with the disorder usually have a family history of psychosis, leading psychiatrists to suspect a genetic component.

PHANTOM LOVER SYNDROME

 
Traditionally, the prognosis and response to treatment is poor. The disorder is overlooked because it is often associated with other well-known psychiatric disorders like schizophrenia, bipolar disorder, and major depression. Treatment involves low-dose neuroleptics and antipsychotic medications. This is sometimes coupled with electroconvulsive therapy for temporary relief of the delusions along with psychotherapy and an adjustment of socio-environmental factors. The success of treatment depends on the co-occurrence with other disorders and the type of erotomania. Although some patients have been cured completely of their erotomanic symptoms with the antipsychotic pimozide, the two longest reported unimproved cases have now been followed up for over 37 and 40 years [2]! 


[1] Rather, The Wellcome Historical Medical Library, 1965, pp 169-184
[2] Jordan et al, J Natl Med Assoc, 2006

by Apoorva Rajiv Madipakkam,
This article originally appeared June 2014 volume 7, issue 02, The Neuroscience of Love