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Multidisciplinary care with antipsychotic use significantly improves outcomes in delusional infestation, especially when patient engagement is maintained. 

According to the study published in the June 2025 issue of British Journal of Dermatology about Delusional infestation (DI), recognized as a psycho-dermatological condition characterized by fixed false beliefs of infestation, often presenting challenges in patient engagement and treatment setting selection.  

Researchers conducted a retrospective study to examine outcomes for individuals with DI referred to multidisciplinary clinics in the UK involving dermatology or tropical medicine and psychiatry.  

They used changes in CGI-S scores as the primary outcome measure and reported average CGI-S changes across all groups. Independent t-tests and ANOVA were performed to compare individuals with planned discharge vs those who failed to follow-up. Each group was further divided based on whether they reported taking antipsychotic medication or not.  

The results showed that records from 465 individuals were reviewed. The CGI-S data were unavailable for 94 (20.2%) cases (12.0% did not attend; 8.2% missing data). A total of 151 (32.5%) had a planned discharge after follow-up, while 193 (41.5%) lost to follow-up, including 63 (13.5%) who attended once and had their last observation carried forward. Among 281 (60.4%) who attended at least 2 sessions, 108 (38.4%) showed response or remission (n=69; 24.6%). The mean CGI-S score change was -1.29, reflecting clinically relevant improvement. Those with a planned discharge who reported medication use had a mean CGI-S change of -2.02, indicating significant improvement. Those who lost follow-up but who took medication showed a smaller change of -0.63 (just below clinically relevant improvement), while individuals who neither completed follow-up nor reported medication use showed minimal change (CGI-S change: -0.07).  

Investigators concluded that individuals with DI had better clinical outcomes when engaged in multidisciplinary care, particularly among those who took medication and completed planned discharge. 

Source: academic.oup.com/bjd/advance-article-abstract/doi/10.1093/bjd/ljaf207/8159568