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Erotomania

Romantic delusional disorder

  • 8 min read
  • 5 chapters

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This disorder is most often seen (though not exclusively) in female patients who are shy, dependent, and sexually inexperienced. The object of the delusion is typically a man who is unattainable due to high social or financial status, already being in a relationship, or lack of interest. The object of obsession may be imaginary, deceased, or someone the patient has never met. Delusions of reference are common, as the erotomanic individual often perceives that they are being sent messages from the secret admirer through innocuous events such as seeing license plates from specific regions.

Symptoms

Erotomania is more common in women, but men are more likely to exhibit violent and stalker-like behaviors. The core symptom of erotomania is that the individual holds an unshakable belief that another person is secretly in love with them. In some cases, the person with the condition may believe several people at once are "secret admirers". Most commonly, the individual has delusions of being loved by an unattainable person who is usually an acquaintance or someone the person has never met. They may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates their love by subtle methods such as body posture, arrangement of household objects, colors, numbers, license plates on cars from specific states and other seemingly innocuous acts‍—‍or, if the person is a public figure, through clues in the media such as coded social media posts and meaningful clothing choices. Some delusions may be extreme such as the conception, birth, and kidnapping of children that never existed or the belief that the individual was predestined or chosen by God to be with the object of their obsession. The delusional objects may be replaced by others over time, and some may be chronic in fixed forms. Denial is characteristic with this disorder as the patients do not accept the fact that their object of delusion may be married, unavailable, or uninterested. The phantom lover may also be imaginary or deceased.

Erotomania has two forms: primary and secondary. Primary erotomania is also commonly referred to as de Clérambault's syndrome and old maid's insanity and it exists alone without comorbidities, has a sudden onset and a chronic outcome. The secondary form is found along with mental disorders like paranoid schizophrenia, often includes persecutory delusions, hallucinations, and grandiose ideas, and has a more gradual onset. Patients with a "fixed" condition are more seriously ill with constant delusions and are less responsive to treatment. These individuals are usually timid, dependent women that are often sexually or socially inexperienced. In those with a more mild, recurrent condition, delusions are shorter-lived and the disorder can exist undetected by others for years. Problematic behaviors include actions like calling and texting, sending letters and unwanted gifts, persistent Internet harassment via social media and email, making unannounced house visits, contacting or attempting to contact the individual's friends, family or co-workers and other persistent stalking behaviors.

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