Diagnosis and treatment of monosymptomatic hypochondriacal psychosis in chronic renal failure

The authors describe a case of a patient who presents with a delusional interpretation of a somatic symptom, uremic pruritus.The literature on the diagnosis and treatment of monosymptomatic hypochondriacal psychosis (MHP) is reviewed and discussed. There is an effective treatment available for this disabling condition — a neuroleptic agent called pimozide, which appears to have a selective ability to block central dopaminergic receptors.