A postmenopausal woman presenting with Ekbom syndrome associated with recurrent depressive disorder: a case report

BACKGROUND: Ekbom syndrome is a rare psychiatric disorder that can manifest as a delusion, overvalued idea or hallucination of parasitic infestations. It is more prevalent in postmenopausal women and patients are usually seeking dermatology rather than psychiatry consultation for their symptoms. CASE PRESENTATION: We present a case of Ekbom syndrome associated with recurrent depressive disorder in an elderly patient. The patient presented with tactile hallucinations of insects crawling just under her skin. These hallucinations resolved with Mirtazepine and electroconvulsive therapy treatment in the absence of an antipsychotic pharmacological agent. CONCLUSION: This case report highlights the presence of a rare psychiatric presentation of Ekbom syndrome within the context of depression. The majority of such cases will not be seen by psychiatrists but by dermatologists. Therefore collaborative consultations between dermatologists and psychiatrists of patients presenting with symptoms of Ekbom are essential for the identification and management of such cases. The case also takes a look at possible aetiologies and the importance of descriptive psychopathology in distinguishing psychotic symptoms in depressive disorder.