Delusional infestation/parasitosis and the law: a review

Delusional infestation (DI) is a psychodermatological condition where sufferers falsely believe they are infested with parasites despite all evidence to the contrary. Besides sparse records of suicide and doctors being assaulted or threatened with legal action by DI patients, few studies have looked at the forensic presentation of DI. This study aimed at describing when and why DI appears in the courtroom. Westlaw and Google Scholar searchers were conducted for relevant articles and legal cases in the USA containing keywords including delusions, insects, bugs, mites, worms, infested, and parasite. The presentation of DI in the courtrooms was compared to its appearance in the general population. Co-morbidity with other mental disorders and/or drug abuse was common, as were other delusions. Evidence of DI has been used in hearings of competency to stand trial and appeals against involuntary commitment or denial of disabilities benefits. Several DI sufferers had filed lawsuits against those they felt failed to properly treat their infestations,' but all were dismissed for failure to state a claim. In several cases, children were deemed at risk directly due to their parents' DI. Increased awareness is needed of DI and its risks, especially for children living with delusional caretakers.