Pathological jealousy appearing after cerebrovascular infarction in a 25-year-old woman.

OBJECTIVE

To report pathological jealousy (Othello syndrome) occurring in a young woman with a right hemisphere cerebrovascular infarction and to review diagnosis and possible organic mechanisms for the generation of this syndrome.

CLINICAL PICTURE: A 20-year-old woman was admitted to hospital with a right hemisphere stroke associated with a history of severe migraine and the use of oral contraceptives. The patient made a good recovery with minimal neurological deficits but 5 years later developed the syndrome of morbid jealousy with depression and a near fatal overdose.

TREATMENT AND OUTCOME: Morbid jealousy subsided, almost completely disappearing over a 6-week period of treatment with a selective serotonin re-uptake inhibitor (SSRI).

CONCLUSIONS

Case reports of the Othello syndrome and other content specific delusions following right hemisphere cerebrovascular infarction have appeared in geriatric psychiatry literature. The occurrence of a similar association in a young patient lends support to the suggestion of a causal relationship and has implications for diagnosis, clinical care and research.