The fixation upon arthropods has some specific and individual meaning in the life history of the person involved, and causes the patient to see a physician, an entomologist, or both. Generally, such problems can be traced to severe infantile or childhood emotional deprivation with lack of basic emotional need fulfillment which is too often glibly explained away solely by present-day problems. For example, for one patient the delusion was precipitated by the shock of an accident in which his sister lost her vision as the result of his negligence. Another common characteristic revealed in the investigations was the patients' excessive preoccupation with cleanliness. She spends her entire time from early morning to late at night cleaning, scrubbing, and sterilizing her home.
All available money is spent on cleaner's bills for clothing, bedding, curtains, and similar items.
She insisted that the family bathe in gasoline daily and rub with sulfur and lard. The entomologist's obligation ends, of course, after he has made his diagnosis from the entomological viewpoint. However, he should make certain that the possibility of insect or mite infestation has been thoroughly investigated. The adviser can usually determine from the nature of the conversation whether the caller with itching sensations really has a pest problem, such as fleas, lice, bed bugs, tropical rat mites, straw itch mites, human itch mites, or the like. The problem of the person really having pests is, of course, generally much easier to solve than the problem of the person who has no pests but believes he has.