Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 1024-1031
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.1024
Concomitant Othello syndrome and impulse control disorders in a patient with Parkinson’s disease: A case report
Tian Xu, Zhao-Sheng Li, Wei Fang, Lan-Xiao Cao, Guo-Hua Zhao
Tian Xu, Zhao-Sheng Li, Wei Fang, Lan-Xiao Cao, Guo-Hua Zhao, Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322200, Zhejiang Province, China
Author contributions: Xu T reviewed the literature and drafted the manuscript; Li ZS and Fang W collected the clinical data; Cao LX contributed to manuscript drafting; Zhao GH revised the manuscript for intellectual content; all authors read and approved the final manuscript.
Supported by Zhejiang Province Medical Science and Technology Project, No. 2018KY872; and Yiwu Science and Technology Bureau Project, No. 20-3-074.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Guo-Hua Zhao, MD, Director, Doctor, Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. N1 Shangcheng Avenue, Yiwu 322200, Zhejiang Province, China.
Received: May 31, 2021
Peer-review started: May 31, 2021
First decision: October 16, 2021
Revised: November 3, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022

Othello syndrome (OS) is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner, which may lead to extreme behaviors. Impulse control disorders refer to behaviors involving repetitive, excessive, and compulsive activities driven by an intense desire. Both OS and impulse control disorders in Parkinson’s disease (PD) may be side effects of dopamine agonists. At present, there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders.


We describe a 70-year-old male patient with PD, OS, and impulse control disorders, who presented with a six-month history of the delusional belief that his wife was having an affair with someone. He began to show an obvious increase in libido presenting as frequent masturbation. He had been diagnosed with PD ten years earlier and had no past psychiatric history. In his fourth year of PD, he engaged in binge eating, which lasted approximately one year. Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine.


Given its potential for severe consequences, OS should be identified early, especially in patients undergoing treatment with dopamine agonists.

Keywords: Othello syndrome, Delusional jealousy, Impulse control disorders, Hypersexuality, Parkinson’s disease, Case report

Core Tip: Both Othello syndrome (OS) and impulse control disorders in Parkinson’s disease (PD) may be considered side effects of dopamine agonist therapy. These syndromes may have severe consequences; thus, when clinical features of either syndrome appear, the features of both syndromes should be investigated further. We report the case of a patient with PD, OS, hypersexuality, and binge eating. The syndrome was alleviated after a reduction of the patient’s pramipexole dosage and the addition of quetiapine.