Clinical and imaging features of Othello's syndrome

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Abstract

Background and Purpose: Our objective was to document the clinical and imaging features of Othello's syndrome (delusional jealousy). Methods: The study design was a retrospective case series of 105 patients with Othello's syndrome that were identified using the Electronic Medical Record system of Mayo Clinic. Results: The average age at onset of Othello's syndrome was 68 (25-94) years with 61.9% of patients being male. Othello's syndrome was most commonly associated with a neurological disorder (73/105) compared with psychiatric disorders (32/105). Of the patients with a neurological disorder, 76.7% had a neurodegenerative disorder. Seven of eight patients with a structural lesion associated with Othello's syndrome had right frontal lobe pathology. Voxel-based morphometry showed greater gray matter loss predominantly in the dorsolateral frontal lobes in the neurodegenerative patients with Othello's compared to matched patients with neurodegenerative disorders without Othello's syndrome. Treatment success was notable for patients with dopamine agonist induced Othello's syndrome in which all six patients had improvement in symptoms following decrease in medication. Conclusions: This study demonstrates that Othello's syndrome occurs most frequently with neurological disorders. This delusion appears to be associated with dysfunction of the frontal lobes, especially the right frontal lobe.

Original languageEnglish (US)
Pages (from-to)38-46
Number of pages9
JournalEuropean Journal of Neurology
Volume19
Issue number1
DOIs
StatePublished - Jan 2012

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Frontal Lobe
Nervous System Diseases
Neurodegenerative Diseases
Jealousy
Delusions
Electronic Health Records
Dopamine Agonists
Age of Onset
Psychiatry
Pathology
Therapeutics

Keywords

  • Delusions
  • Dementia
  • Othello's syndrome
  • Right frontal lobe

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

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abstract = "Background and Purpose: Our objective was to document the clinical and imaging features of Othello's syndrome (delusional jealousy). Methods: The study design was a retrospective case series of 105 patients with Othello's syndrome that were identified using the Electronic Medical Record system of Mayo Clinic. Results: The average age at onset of Othello's syndrome was 68 (25-94) years with 61.9{\%} of patients being male. Othello's syndrome was most commonly associated with a neurological disorder (73/105) compared with psychiatric disorders (32/105). Of the patients with a neurological disorder, 76.7{\%} had a neurodegenerative disorder. Seven of eight patients with a structural lesion associated with Othello's syndrome had right frontal lobe pathology. Voxel-based morphometry showed greater gray matter loss predominantly in the dorsolateral frontal lobes in the neurodegenerative patients with Othello's compared to matched patients with neurodegenerative disorders without Othello's syndrome. Treatment success was notable for patients with dopamine agonist induced Othello's syndrome in which all six patients had improvement in symptoms following decrease in medication. Conclusions: This study demonstrates that Othello's syndrome occurs most frequently with neurological disorders. This delusion appears to be associated with dysfunction of the frontal lobes, especially the right frontal lobe.",
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