MORBID JEALOUSY

This disorder of content, described by Ey (1950), may be manifested in various forms; for example, delusion, overvalued idea, depressive affect, anxiety state.

The feeling of jealousy, coupled with a sense that the loved object 'belongs to me”, is part of normal human experience; it is of social value in marital relationships for preserving the family. Various terms have been used to describe abnormal, morbid or malignant jealousy. Kraepelin used the term sexual jealousy'. Enoch and Trethowan (1979) have considered it important to distinguish psychotic jealousy from other types; and this is dependent on demonstration of a delusion of infidelity . It is sometimes difficult to distinguish understandable jealousy from that that which is clearly delusional.

An undisputed delusion of being the victim of infidelity without other psychotic symptoms has been described (Todd & Dewhurst, 1955). This identifiably delusional when the belief of the spouse is based on delusiona evidence. Such delusions are resistant to treatment and do not change with time. A patient was very concerned that his wife was being unfaithful with numerous pleope, including his boss, her general practitioner and others. Four years later despite various treatrnents, his belief was unchanged, but he said, 'I don't blame her now. She is much younger than I am and everyone does that sort of thing'. Delusions of jealousy are common in alcoholism. for instance, Shrestha e: al (1985) found sexual jealousy to be present in 35% of alcoholic men and 31% of women.

As jealousy appeared to be justified in some cases, morbid jealousy was considered to be present in 27% of men and 15% of women. Delusional jealousy also occurs in some organic states, for example the punch-drunk syndrome of boxers on following multiple contra-coup contusion. Quite frequently the spouse wearied by continued accusations of infidelity, does form another sexual ivolvement, which may result in an acute exacerbation in the mental state of the patient and further marital conflict.

The sexual content of the delusion is obvious and all-important . Jealousy is directed towards the sexual partner. The deluded person is very attached to, and often emotionally utterly dependent upon, the other; he may have a sense owing her completely. The victim is often much more sexually attractive than the deluded partner; for instance, a young wife or a sociable and popular husband. The deluded person may have been promiscuous in the past and therefore resignedly expects his spouse to show similar behaviour. He may have become impotent and projected the blame for his failure onto her. He may have homosexual fantasies directed towards the men with whom he claims his wife is consorting. Morbid jealousy arises with the belief that there is a threat to the exclusive possession of his wife, but this is just as likely to occur from conflicts inside himself-his own inability to love or his sexual interest directed toward someone else-as from changing circumstances in his environment or his Wife's behaviour. Husbands or wives may show sexual jealousy; as may cohabitee and homosexual pairs. Jealousy is particularly prominent in these latter two types of relationship since the insecurity of a liaison not condoned by law is especially likely to germinate suspicion. Crimes of violence are more frequently associated with morbid jealousy than with any other psychopathology.