| Acrophobia (Fear of Heights) 2
associated with delusional parasitosis include time-consuming examination of
the skin and body, use of instruments (e.g., tweezers, magnifying glasses) to
facilitate examination or to extract the parasites, maintenance of notes or draw-
ings of the infestation, attempts to photograph or catch the parasites as proof of
the infestation, and frequent visits to dermatologists, general practitioners, and
other health-care providers, as well as to pest control specialists and entomolo-
gists. Visits to mental health providers are much rarer, as individuals with delu-
sional parasitosis do not believe that the source of their problem is psychiatric
in nature. Notably, individuals diagnosed with the primary form of the disorder
typically present with a pattern of logical thinking and appropriate behavior in
all other aspects of their life.
Individuals with delusional parasitosis often reject their diagnosis. When left
untreated, the course of the disorder in the primary form tends to be chronic.
Atypical antipsychotic medication is the first-line treatment for the primary form,
whereas in cases where delusional parasitosis is secondary to another condition,
treatment is geared toward the underlying condition.
Irena Milosevic
See also: DSM-5; Entomophobia (Fear of Insects)
Further Reading
Freudenmann, Roland W., & Lepping, Peter. (2009). Delusional infestation. Clinical
Microbiology Reviews, 22, 690–732.
Acrophobia (Fear of Heights)
Originating from the Greek words akron (peak or summit) and phobos (fear), acro-
phobia is an unrealistic or excessive fear of heights that may be triggered by a
wide range of situations that involve being high off the ground, such as being on
a high floor of a building; standing on a bridge, balcony, ladder, or chair; taking
an elevator to a high floor; and climbing stairs. In the Diagnostic and Statistical
Manual of Mental Disorders, fifth edition, acrophobia is classified as a specific
phobia, situational type, and is among the most prevalent of the phobias, affecting
up to 5% of individuals in their lifetime (Depla, ten Have, van Balkom, & de Graaf,
2008). Individuals with acrophobia fear that they might fall or lose their balance
when they are a certain distance off the ground; consequently, they experience
anxiety symptoms that may escalate into a full-blown panic attack when in feared
situations. Often feared situations are avoided altogether. Given the breadth of situ-
ations that can trigger the fear, individuals with acrophobia experience significant
impairment in their life (Depla et al., 2008). For example, they may avoid taking
certain jobs (e.g., a construction worker who is asked to work on a high floor) or
