Erotomania

Erotomania is a type of delusional disorder where the affected person believes that another person is in love with him or her. This belief is usually applied to someone with higher status or a famous person, but can also be applied to a complete stranger. Erotomanic delusions often occur in patients with schizophrenia and other psychotic disorders, but can also occur during a manic episode in the context of bipolar I disorder. During an erotomanic delusion, the patient believes that a secret admirer is declaring his or her affection for the patient, often by special glances, signals, telepathy, or messages through the media. Usually the patient then returns the perceived affection by means of letters, phone calls, gifts, and visits to the unwitting recipient. Even though these advances are unexpected and often unwanted, any denial of affection by the object of this delusional love is dismissed by the patient as a ploy to conceal the forbidden love from the rest of the world.

Erotomania is also called de Clérambault's syndrome, after French psychiatrist Gaëtan Gatian de Clérambault (1872–1934), who published a comprehensive review paper on the subject (Les Psychoses Passionnelles) in 1921. The term erotomania is often mistakenly confused with obsessive love, obsession with unrequited love, or hypersexuality.

Presentation

The core symptom of the disorder is that the sufferer holds an unshakable belief that another person is secretly in love with them. In some cases, the sufferer may believe several people at once are "secret admirers." The sufferer may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates his or her love by subtle methods such as body posture, arrangement of household objects, and other seemingly innocuous acts (or, if the person is a public figure, through clues in the media). Erotomanic delusions are typically found as the primary symptom of a delusional disorder or in the context of schizophrenia and may be treated with atypical antipsychotics.

Well-known cases

In his paper that described the syndrome, de Clérambault referenced a patient he had counselled who was obsessed with British monarch George V. She had stood outside Buckingham Palace for hours at a time, believing that the king was communicating his desire for her by moving the curtains.

Parallels were drawn between this and a 2011 case where the body of a homeless American man was found on a secluded island within sight of Buckingham Palace. The man had sent hundreds of "strange and offensive" packages to Queen Elizabeth II over the previous 15 years.

The assassination attempt on Ronald Reagan by John Hinckley, Jr. was reported to have been driven by an erotomanic fixation on Jodie Foster, whom Hinckley was attempting to impress.

Late night TV entertainer David Letterman and former astronaut Story Musgrave were both stalked by Margaret Mary Ray, who suffered from erotomania.

History

M.S.P. "Female patient suffering from erotomania," from Alexander Morison's The Physiognomy of Mental Diseases

Early references to the condition can be found in the work of Hippocrates, Erasistratus, Plutarch and Galen. In the psychiatric literature it was first referred to in 1623 in a treatise by Jacques Ferrand (Maladie d'amour ou Mélancolie érotique) and has been variously called, "erotic paranoia" and "erotic self-referent delusions" until the common usage of the terms erotomania and de Clérambault's syndrome.

G. E. Berrios and N. Kennedy outlined in 'Erotomania: a conceptual history' (2002) several periods of history through which the concept of erotomania has changed considerably:

• Classical times – early eighteenth century: General disease caused by unrequited love
• Early eighteenth – beginning nineteenth century: Practice of excess physical love (akin to nymphomania or satyriasis)
• Early nineteenth century – beginning twentieth century: Unrequited love as a form of mental disease
• Early twentieth century – present: Delusional belief of "being loved by someone else"

In one case, erotomania was reported in a patient who had undergone surgery for a ruptured cerebral aneurysm.

In media

The horror of erotomania and unrequited love can be seen in these films:

• Play Misty for Me
• Ingrid Goes West
• Fatal Attraction
• Enduring Love (Ian Mckewan novel)

Erotomania is also in:

• Criminal Minds: season 1 episode 5 "Broken Mirror", episode 18 "Somebody's Watching"; and season 8 episode 9 "Magnificent Light"

See also

• Adèle Hugo
• Delusion
• Delusional disorder
• Erotolepsy
• Love addiction
• Monomania
• Psychosis
• Schizophrenia
• Stalking
• Limerence

References

• Berrios GE, Kennedy N (December 2002). "Erotomania: a conceptual history". History of Psychiatry. 13 (52 Pt 4): 381–400. doi:10.1177/0957154X0201305202. PMID 12638595.
• Fitzgerald P.; Seeman M.V. (2002). "Erotomania in women". In Sheridan, Lorraine; Boon, Julian (eds.). Stalking and psychosexual obsession: Psychological perspectives for prevention, policing, and treatment. New York: Wiley. ISBN 0-471-49459-3.
• Giannini AJ, Slaby AE, Robb TO (February 1991). "De Clérambault's syndrome in sexually experienced women". The Journal of Clinical Psychiatry. 52 (2): 84–6. PMID 1993641.
• Kennedy N, McDonough M, Kelly B, Berrios GE (2002). "Erotomania revisited: clinical course and treatment". Compr Psychiatry. 43 (1): 1–6. doi:10.1053/comp.2002.29856. PMID 11788912.
• Munro, Alistair (1999). Delusional disorder: Paranoia and related illnesses. Cambridge, UK: Cambridge University Press. ISBN 0-521-58180-X.