Page 32 - JCBP-3-2

Journal of Clinical and
Basic Psychosomatics Morgellons: Delusion or disease

Morgellons with a DI; one of these studies has been associated with self-inflicted wounds rather than any
included in our discussion. 33 known dermatological condition. The fibers and other
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materials often presented by patients as evidence of
5.1. Morgellons as a delusional disorder Morgellons have been identified through forensic analysis
A delusional disorder is characterized by the presence of one as common environmental fibers such as those from
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or more delusions for a month or longer in a person who, clothing. However, some lesions can be present in areas
except for the delusions and their behavioral ramifications, that do not correlate to self-inflicted lesions.
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does not appear odd and is not functionally impaired. The CDC conducted a large study because of the
Morgellons has been described as a DI/parasitosis, which increasing enquiries regarding the symptoms described
is a subset of delusional disorders. 25 by patients with Morgellons and highlighted the
Most studies have highlighted a few key reasons, consistent common psychiatric etiologies in patients
mentioned in the below subsections, for Morgellons being with Morgellons. Furthermore, there was no significant
considered a delusional disorder. evidence of clinical abnormalities that strongly supported
an infectious etiology. In one adult, woman with
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5.1.1. Lack of medical evidence ulcerative lesions on her face, arms, and trunk, numerous
Numerous studies have failed to identify any infectious investigations, including microscopic visualizations
26
agents or parasites in patients reporting Morgellons of fibers and biopsy, were performed. However, the
symptoms. Some researchers have demonstrated an authors concluded that the patient had a DI in the form
association between Lyme disease and Morgellons. of Morgellons; they found no evidence of a Borrelia
However, these studies are often limited in size, with little infection, which would demonstrate a link between
correlation. When examined by histopathologists, the Morgellons and Lyme disease. The aforementioned
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lesions, and fibers are often self-inflicted or environmental findings will be further explored in later sections. In
contaminants rather than fibers of biological or pathological several patients with previous skin conditions, after the
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origin. Thus, the condition is considered a psychosomatic initial symptoms such as those of seborrheic dermatitis
manifestation rather than an actual skin infestation. 37 were treated, patients continued to experience symptoms
leading to the classical excoriations and symptoms as
5.1.2. Psychiatric associations described; this indicated that several patients with
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Morgellons may exhibit a combined dermatological and
Although there is much debate whether Morgellons is a psychological origin.
psychiatric or dermatological problem, most evidence
suggests that Morgellons disease is a psychosomatic 5.2. Psychological and neuropsychiatric hypotheses
disorder. Many patients diagnosed with Morgellons Histopathological examination of lesions from patients
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exhibit characteristics similar to delusional or other
psychotic disorders, such as schizophrenia. These delusions with Morgellons does not demonstrate consistent
spirochetal findings, making it an unreliable diagnostic
primarily revolve around the belief of being infested with feature. A CDC-supported study examining 115 patients
parasites or foreign material. 15
with Morgellons did not report any parasites in the biopsy
5.1.3. Response to treatment samples. 1
Many patients with unresolved symptoms have been Some studies report Morgellons as a psychosomatic
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successfully convinced by the first dermatologist to be condition, a somatic type of DI. In this condition, the
consulted to try psychiatric therapies after unsuccessfully patient is unarguably convinced of the severity of their
administering dermatological therapies. Those treated symptoms, and their perception of reality is impaired
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with antipsychotic medications have reported improved Studies have highlighted structural brain differences in
symptoms. When patients are treated with psychotropic patients with delusional disorders, including differences
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medications rather than antiparasitic drugs, symptoms are in the “volume of grey and white matter, cortical thickness,
reportedly reduced, potentially supporting that the origin surface area, folding patterns, and the presence of lesions” on
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of Morgellons is a psychosomatic manifestation. magnetic resonance imaging. Thus, one theory proposes
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that the brain’s neuronal pathways could be disturbed in
5.1.4. Clinical observations
patients with Morgellons, potentially altering how they
Dermatologists and psychiatrists treating patients perceive external stimuli. Reportedly, the “fronto-striato-
with Morgellons frequently report that the physical thalamo-parietal network” could be affected in patients with
manifestations, such as skin lesions, align with behaviors delusions, entailing a disturbance in the frontal cortex and
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Volume 3 Issue 2 (2025) 26 doi: 10.36922/jcbp.4735