Page 36 - JCBP-3-2

Journal of Clinical and
Basic Psychosomatics Morgellons: Delusion or disease

approach for reducing the compulsive behaviors and communities in spreading misinformation and promoting
distress observed in Morgellons. 63 unproven treatments. This has increased self-diagnosis and
8
Another technique used to treat Morgellons is the use of non-evidence-based medical practices, including
70
hypnotherapy, which reduces the associated physical and potentially harmful substances. Conspiracy theories may
psychological symptoms. This approach involves six 1-h have further stigmatized the disease, preventing patients
71
hypnotherapy sessions in a week, supplemented by listening from accessing appropriate medical care.
to two CDs of recorded hypnosis sessions daily between 9.2. Patient–doctor dynamics
sessions or as often as desired. However, the effectiveness of
this approach is based on the findings of a single case study; Morgellons are considered underdiagnosed because patients
therefore, further studies are required to determine whether typically consult dermatologists and other medical specialists
these results can be generalized to a large population. 64 instead of psychiatrists, delaying the diagnosis and treatment.
Even when patients visit a psychiatrist, many fail to follow
Finally, regular follow-up of the patients enhances through with the therapy, leading to poor follow-up. 7,9
adherence to pharmacotherapy and improves treatment
42
outcomes. Each patient responds differently to therapeutic The uncertainty surrounding Morgellons and its origin
1
interventions. Although some treatments may improve poses a threat to the foundations of a strong doctor–
and alleviate the symptoms in some patients, they provide patient relationship and patient trust. To construct
minimal improvement in others. Thus, perhaps a more a robust therapeutic doctor–patient relationship, a
patient-centered approach is required while dealing with collaborative effort is paramount. Collaboration between
Morgellons. A novel approach incorporating precision multidisciplinary teams and the doctor and patient ensures
psychiatry should be considered, in which a combination a level of trust. When patients are frustrated because of a lack
of genetic, environmental, and lifestyle factors can be used, of clarity, there is a risk of non-adherence to treatment and
adopting the same principles of precision medicine as that seeking alternative options. Non-adherence to treatment
used in personalized care. 65 must be minimized at all stages because of the risk of
adverse clinical outcomes, long and complex treatment
9. Additional factors to consider pathways, and an increased cost of care. According to
clinicians, taking a neutral stance with patients where their
9.1. Social and cultural factors symptoms are acknowledged and validated is advisable
Social media has permeated the patient and public sectors, while admitting the absence of observable organisms. 31
providing access to information on a wide range of diseases. The stigma associated with the diagnosis of a mental
There are several Morgellons-centered communities across health disorder should also be considered because it
Facebook, Reddit, and other online forums. These communities can lead to harmful effects such as poorer outcomes of
enable individuals to share their experiences and validate symptoms, non-adherence to treatment, and difficulty
their feelings. Reddit threads have highlighted the underlying in building strong social relationships, including a
debate between whether Morgellons is a delusion or a true professional doctor–patient relationship. Given the rarity
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disease, with affected individuals and families expressing the and poorly understood nature of Morgellons, patients can
perpetuating cycle of being reviewed by a dermatologist and have little insight into their condition, resulting in hesitancy
therapist without receiving any real conclusive answer on how based on the societal stigma attached with a psychiatric
to support and cope with the long-term. 66,67 diagnosis. The lack of studies on Morgellons indicates that
Social media and cultural perceptions about the patients may not always have their questions answered by
diagnosis can be informative as well as misleading. clinicians. This can affect treatment adherence despite a
Information shared on the Internet can influence the referral from a dermatologist. 73
spread of Morgellons-related information positively and Psychodermatology services such as those provided by
negatively because patients seek explanations for their the Royal London Hospital allow a consultant dermatologist
symptoms. The Internet, with its abundant information, and liaison psychiatrist to see patients with Morgellons
8,68
allows patients to learn about their condition and find together. This will enable them to deal simultaneously with
74
answers that clinicians struggle to provide in detail. This dermatological diseases and psychosocial comorbidities,
has resulted in the creation of the Morgellons Research allowing holistic medical input from other team members
Foundation, an online community where the affected such as child and adolescent psychiatrists in managing
individuals can discuss their condition. 67,69 these conditions, shared decision-making, empowering
Morgellons has been described as an “Internet- the patient, and the liaison psychiatrist and dermatologist
transmitted disease,” emphasizing the role of online to devise a shared care plan and clear follow-up direction.

Volume 3 Issue 2 (2025) 30 doi: 10.36922/jcbp.4735