Download Incubus Syndrome as precursor of Schizophrenia

Nova Explore Publications
Nova Journal of Medical and Biological Sciences
PII: S2292793X1200004-1
Vol. 1(1), 2012:1-2
www.novaexplore.com
Case Report
Incubus Syndrome as precursor of Schizophrenia
Masoud Amin1, Moazzame Mohammadi 1 , Reza Bidaki1
1
Rafsanjan University of Medical sciences, Rafsanjan, Iran
Corresponding Author: Reza Bidaki; E-mail: [email protected]
Abstract
Incubus syndrome is a rare disorder which has very restricted case reports. It is a type of erotomania that is in group of delusional
disorders. Case Presentation : we intend introduce 23 years - old rural female student patient living in dormitory far from her
family who was referred with bizarre delusion and behaviors. Results : Recognition of the precursor syndromes can aid
psychiatrists to detect early symptoms of schizophrenia that, if cured at this stage, can cause to a more favorable long-term
prognosis.
Conclusio: It suggests that Incubus Syndrome can consider as precursor of Schizophrenia.
Keywords: Erotomania; Incubus syndrome; Precursor; Schizophrenia
Introduction
Incubus syndrome or demonic lover is a term to describe patients suffering from the fixed belief that they have been sexually
approached nightly by an unseen lover (1). It is a type of the secondary erotomania, was described as the delusional belief “memory” of an imposed raped by an imaginary lover (2-5). Schizophrenia is a chronic, debilitating psychotic mental disorder that
affects about 1 percent of general population. It is now believed that there is combination between multiple genetic bases and
environmental factors (6). Its symptoms generally begin in late adolescence or early adulthood and usually continue throughout life
(7). Schizophrenia may demonstrate several precursor symptoms at first such as kleptomania, OCD, eating disorder, somatization
disorder and etc (8). We intend suggest Incubus syndrome as a precursor and prodromal for schizophrenia . We didn't find it
in previous reports.
Case Presentation
Here we have a 23 years - old rural single female student living in dormitory far from her family who was referred by a General
physician in university with bizarre delusion and behaviors. She was entering other students' rooms in dormitory and tried to
arrest a man entering nightly to girls dormitory for sexual intercourse with them ( stalking and fixed false belief), and to
prove her delusion, she hang a wire on the door of rooms. There was a potential risk for violent behavior by patient. She was asleep
at night and lived lonely in dormitory. She had obsession with this thought. In interview, She was guarded and non- cooperative
, depressed mood, tense , suspicious, poor insight , constricted affect. She was a paranoid patient that it was probable that we
lie in her delusional system. She hadn’t sexual experience. Her parents were low educated and lower limit of normal IQ. The
parents hadn’t history for psychiatric or organic disorders. She was treated as Incubus Syndrome by antipsychotics, anti-depressant
and Electro convulsive therapy . We prescribed her; Tablet. Risperidone 2mg at night ,Tablet. Citalopram 20 mg/daily and Tablet.
Clonazepam 1mg at night. But she refuse of drug consumption and she was regressed .Legal problems in university and even
out of it were considerable. We were obligated for forced admission. It is considered six sessions Electro convulsive
therapy for her because poor drug compliance. Developmental delay and problematic delivery were not found. Brain Magnetic
resonance and Routin lab tests were normal. After 2 weeks , the symptoms were resolved significantly and she was
discharged , she discontinued her treatment ( She was very guard and resistant in treatment ) and in a one year follow up she
showed auditory and visual hallucinations, negative symptoms, bizarre symptoms, psychosocial regression (leaving college due to
inability of studying and disturbance for other students in dormitory) and inability of normal functions which resulted diagnosis of
Schizophrenia. She withdrawn academy and she wasn't able to keep on education. In fact Incubus Syndrome was a precursor
for Schizophrenia.
In 1980, It is reported a woman diagnosed erotomania. At that time, she had been followed for nearly 8 years that diagnosis was
established (2).
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Discussion
Incubus syndrome is a rare disorder which has very limited case reports. It is a type of erotomania that is in group of delusional
disorders. By searching reliable, credible and well known data bases such as PubMed we believe that it is the first report of
Schizophrenia which presented with Incubus syndrome at early stages. Since both delusional disorder and Schizophrenia are both
related to dopamine tract malfunction (8) it seems to be the best explanation for that. In psychiatry resources, it is explained some
precursors
for schizophrenia. Precursors
are
include: Somatization disorder, kleptomania, anorexia nervosa, ObsessiveCompulsive disorder. But Incubus syndrome isn't been suggested in onset of schizophrenia. Of course this statement maybe a
unknown word for some of psychiatrist. We tried find history of love failure , but she didn't say it. We are believed that
onset of illness with this disorder will worth the prognosis. There wasn’t a considerable gap between the appearance of
symptoms and the diagnosis of schizophrenia in this case. First episode of schizophrenia is nearly in 3th decades of age in
women .It maybe suggest that onset of schizophrenia with Erotomania or Incubus syndrome may advance onset of
schizophrenia. In Erotomania , individual has a delusional belief that a person of higher socio-economic status falls in love and makes
amorous advances towards him/her (9). But in our study, patient didn't mention a higher social level person and amorous was
toward other sisters . In previous study , It was reviewed the studies about Erotomania that it was indicated more
prevalent in patients with developmental disabilities (10). Regression in university achievement, job or other intellectual
functioning has been known to be a precursor signs in schizophrenia since Bleuler’s descriptions (11-13). Progression of psychotic
symptom in our case cause that she can't keep education, too. Recognition in the precursor syndromes can help psychiatrists
to detect early symptoms of schizophrenia that, if cured at this stage, can cause to a more favorable long-term prognosis. The
final goal is to aid prevent people at risk from becoming schizophrenia.
Conclusion
It suggests that Incubus Syndrome can consider as precursor of Schizophrenia.
References
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