BACKGROUND:

Erotomania, as a primary disorder, is categorized in DSM-III-R under delusional (paranoid) disorder. However, erotomanic delusions also are seen frequently in the context of other psychiatric disorders. There is increasing evidence that patients with such delusions often have an underlying affective disorder and effective treatment of the underlying disorder can lead to resolution of the erotomanic delusions.

METHOD:

The case histories of three patients with prominent affective features and erotomanic delusions are presented.

RESULTS:

Each patient was treated with bilateral electroconvulsive therapy (ECT) after experiencing treatment failure with numerous other somatic therapies. One showed only a slight and transient improvement, while two demonstrated resolution of the erotomanic delusions.

CONCLUSION:

Bipolar and schizoaffective disorder should be considered in patients with erotomanic delusions, and ECT may offer an effective alternative when other somatic treatments have failed.