Neuropsychologic implications in erotomania: two case studies.

Objective: To explore neuroanatomic substrates and cognitive factors associated with erotomania through neuropsychologic test data and neurologic studies.

Background: Erotomania is a delusional disorder that has been examined and conceptualized both clinically and psychodynamically. It is believed that neuroanatomic and neuropsychologic correlates can provide important insights into the causes of erotomania.

Method: Two patients with erotomania and the results of their neuropsychologic testing were examined, and neurologic studies also were examined for one of the patients. These data were compared with case studies from the literature.

Results: Neuropsychologic test results suggested that erotomania may be associated with deficits in cognitive flexibility and associative learning that are mediated by frontal-subcortical systems, and with deficits in verbal and visuospatial skills. Neurologic studies suggested abnormalities in temporal areas.

Conclusions: Visuospatial-functioning deficits or limbic lesions, particularly in the temporal lobes, in combination with isolative and ambivalent romantic experiences, may contribute to misinterpretations in erotomania, and deficits in cognitive flexibility may contribute to the maintenance of the delusional belief.