Studies show that psychosis is a possible complication of a stroke but it’s rare, with an incident rate of about 1 percent. Her delusion seems to be very focused. She might have what is called delusional jealousy. A set of German researchers documented a rare case of a stroke victim who experienced delusional jealousy, a syndrome which they referred to as “organic Othello syndrome.”
In their 2012 case study, they describe a 49-year-old female with no history of psychiatric illness who had a stroke and subsequently developed the delusion that her husband was having an affair with one of her friends. The authors reported that she was unshakable in her beliefs despite there being no evidence to support her accusation. The alleged affair made her very upset to the point where she would angrily throw household items at her husband. She demonstrated no other psychiatric symptoms. The authors theorized that her symptoms might have been the result of brain damage suffered from the stroke. Typical treatments for post-stroke psychosis include psychotropic medications.
It’s important that your brother immediately report these symptoms to her doctor. Though she does allow him to go to the doctor with her, that doesn’t preclude him from contacting her doctor. He could either call or write a letter detailing her symptoms and his concerns. The doctor might not be able to respond, given health privacy laws, but there’s nothing that prevents your brother from contacting her doctor and reporting his concerns.
Your brother should also ask the doctor for advice about how to handle this situation. He or she might be in the best position to help your brother and his wife.
In the interim, there are some resources that may be of assistance to your brother in dealing with the accusations. Dr. Xavier Amador has written a good book that many people have found helpful called I Am Not Sick I Don’t Need Help: How To Help Someone With Mental Illness Accept Treatment. The book provides practical advice for families dealing with a loved one who is experiencing a break with reality.
Hopefully, once her doctor is made aware of the problem, he or she will be able to help. If not, your brother may want to consult other health care professionals who specialize in psychosis or organic brain disorders. Please take care.
Dr. Kristina Randle