Erotomania Variants in Dementia

Abstract

Erotomania is a delusional syndrome in which an affected individual is convinced that another person loves him or her. Erotomania usually occurs in middle-aged female patients. Only 3 cases have been described in dementia so far. The authors report 2 cases, in Alzheimer’s disease and vascular dementia, in which erotomania emerged in the early stage of the underlying disorder. In both cases, erotomania partially responded to antipsychotic treatment. Erotomania may be understood in evolutionary terms as a pathologic deviation of an evolved psychological mechanism relating to mate selection and may therefore account for the typical sex distribution of the syndrome in favor of women and the onset of the disorder, usually during the late reproductive phase. The association of erotomania with dementing disorders may tentatively be interpreted to suggest that such complex psychological mechanisms and behaviors as involved here in “organic” delusions may have distinct, “hard-wired” representations in the human brain.