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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1232

Erotomania at the boundary between autonomy and protection: a case report

EROTOMANIA AT THE BOUNDARY OF AUTONOMY AND PROTECTION: A CASE STUDY

An erotomanic delusion becomes clinically significant when it translates into behavior that affects others’ boundaries, and proportionate, time-limited intervention may create the conditions for restoring autonomy.

The aim of this presentation is to discuss, through a case report, the clinical and ethical issues that erotomania (de Clérambault syndrome) raises at the boundary between autonomy and the duty to protect others. Erotomania is defined by a fixed belief that another person is secretly in love with the patient despite the absence of evidence of reciprocity. Although rare, it can have significant interpersonal and occupational consequences through persistent attempts at contact and boundary violations. The case presented concerns a 51-year-old woman who developed a fixed erotomanic delusion focused on a male coworker. The patient interpreted gestures, glances, and everyday interactions as coded expressions of romantic interest; despite explicit rejection and institutional mediation, her belief remained unchanged, and she lacked insight. The clinical course progressed from romantic interpretations to repeated attempts at contact, boundary violations, and escalating workplace conflict. Involuntary hospitalization became necessary in the context of the persistent delusional belief and lack of insight; antipsychotic treatment reduced the intensity of the delusion and partially improved reality testing. The authors discuss the point at which a fixed belief becomes clinically significant through its behavioral consequences, how autonomy should be balanced against the protection of another person’s boundaries, and whether temporarily restricting autonomy can enable its restoration. In conclusion, the presentation emphasizes that psychiatric care must strike a balance between autonomy, risk, and the protection of interpersonal boundaries, and that proportionate, time-limited intervention may lay the groundwork for restoring autonomy.

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