Reprinted with permission from Ahopeful – (The Author)
Source : Here …
Delusions of delusions of parasitosis (sometimes known as DODOP or DDP) is a poorly understood but increasingly common condition, most frequently seen amongst dermatologists, although it can affect physicians of any specialty.
Sufferers of delusions of delusions of parasitosis present with a fixed conviction that a patient (and in severe cases multiple patients) are suffering from delusions of parasitosis. This belief remains firmly held by the afflicted physician, despite being presented with clear evidence of somatic pathology in his or her patient(s). Affected physicians will appear otherwise rationale and rarely display psychiatric comorbidities.
A characteristic sign of delusions of delusions of parasitosis is a refusal for the physician to conduct more than a cursory examination of patients presenting with symptoms of parasitical infestation. In the most extreme cases the physician will also refuse to engage in a professional doctor/patient dialogue.
Whilst the etiology of delusions of delusions of parasitosis remains unknown, there exist several hypotheses as to it’s origin.
One such hypothesis states that delusions of delusions of parasitosis is in fact a ‘meme’, commonly taught to vulnerable physicians in training. Once this belief takes hold, it is extremely difficult for the sufferer to free themselves of this conviction and it becomes increasingly difficult – if not impossible – for the sufferer to approach unfamiliar cases of parasitical infestation without diagnosing delusions of parasitosis.
A modern variant of this hypothesis states that delusions of delusions of parasitosis is an ‘internet disease’ – whereby physicians inadvertently reinforce each others delusions of delusions by reading about them online.
When pressed, sufferers will classically cite flawed, poorly researched and dated medical literature in an attempt to justify their beliefs. They will then go on to transfer their belief system to younger physicians who become similarly deluded. It is thought such cycles have served to perpetuate this condition amongst the medical community – where it has believed to have existed, to a greater or lesser extent, for some 75 years.
The prevalence of delusions of delusions of parasitosis is unknown, and case studies in the literature are few. Some have estimated that over 90% of dermatologists in the UK alone suffer from delusions of delusions of parasitosis. In recent years reports of delusions of delusions of parasitosis have displayed a worrying upward trend.
Treatment of delusions of delusions of parasitosis is troublesome. It is sometimes recommended that the patient attempt to strike up a ‘rapport’ with the physician, in order to gain their trust, and perhaps open their mind to the possibility of explanations other than delusions in patients presenting with symptoms of unfamiliar parasitical-like infestation. However this approach is difficult and is thought to have a fairly low success rate. The physician’s delusions of delusions are frequently firm and will remain in place despite the most striking and rationale evidence to the contrary.
If directly confronted, afflicted physicians may even respond by accusing the patient of suffering from delusions of delusions of delusions of parasitosis, although evidence for this advanced phenomena is beyond the scope of this review and will not be discussed here.
In any case, no randomized controlled trials into the treatment of delusions of delusions of parasitosis have been conducted, and currently it is recommended that it be managed on a case by basis.
Strategies to overcome delusions of delusions of parasitosis in the medical community have been proposed. One such strategy is for patients to apply continued pressure on government bodies to properly investigate increasing reports of parasitical-like conditions in their populations. It is hoped that this approach, whilst by no means a ‘quick fix’, will yield a gradual improvement, and – it is at least hoped – bring some relief to the thousands of physicians currently believed to be suffering from this debilitating illness.