Erotomania

Erotomania, also known as de Clérambault syndrome, is a rare psychiatric condition in which an affected person holds a delusional belief that another person, often of higher social status or a public figure, is in love with them. The conviction is typically resistant to contrary evidence and may be accompanied by the belief that the other person sends hidden messages or signs.

Clinically, erotomania can lead to stalker-like behaviors, repeated attempts to contact the object of affection, and misinterpretation of ordinary social cues as reciprocation. The delusion is sometimes part of a broader psychotic disorder, or may occur in isolation (primary erotomania). Onset is usually in early adulthood; gender distribution has varied across studies, with older literature describing a female predominance.

Classification and diagnosis: In DSM-5, erotomania is recognized as a specifier for delusional disorder (delusional disorder, erotomanic type). It can also appear in the context of schizophrenia or mood disorders with psychotic features. Diagnosis rests on persistent delusional belief of being loved by another person, lasting at least a month, with absence of other diagnostic criteria that would explain the delusion.

Treatment and prognosis: Management typically involves antipsychotic medications and psychotherapy, alongside risk assessment and safety planning when stalking or harassment is a concern. Insight is often limited, and treatment adherence influences prognosis; some individuals improve with treatment, while others have a chronic course or relapse.

History: The condition was first described by Gaëtan de Clérambault in 1921 and is named after him.