Subduing the Green-eyed Monster: Bridging the Psychopharmacological and Psychosocial Treatment Perspective in Understanding Pathological Jealousy

Author(s): Farah Deena Abdul Samad, Hatta Sidi*, Jaya Kumar, Srijit Das, Marhani Midin, Nurul Hazwani Hatta

Journal Name: Current Drug Targets

Volume 20 , Issue 2 , 2019

  Journal Home
Translate in Chinese
Become EABM
Become Reviewer

Graphical Abstract:


Human being is not spared from a broad-ranged emotional state, including being jealous. Jealousy has both affective-cognitive and behavioural-evaluative dimension where the person perceives, or experiences a real threat on a valued relationship. As this complex emotion becomes irrational and not amenable to reason, it later transforms into a dangerously ‘green-eyed monster’. This perilous situation which is viewed as pathological jealousy is a form of delusion, which is maintained by a fixed and false reasoning in an originally entrusted intimate relationship. Pathological jealousy is equally prevailing among both gender, and with a greater ubiquity among the geriatric population. The role of dopamine hyperactivity in the fronto-parietal-temporal region was implicated, with the anatomical mapping of the ventromedial prefrontal cortex (vmPFC), cingulate gyrus (CG), and amygdala involvement in the context of the disease’s neurobiology. The etiology of pathological jealousy includes major psychiatric disorders, i.e. delusional disorder, schizophrenia, mood disorder, organic brain syndrome, and among others, the drug-induced psychosis. The role of relationship issues and psychodynamic perspective, i.e. psychological conflicts with dependence on a romantic partner, and low self-esteem are involved. Pathological jealousy inherits high-risk forensic psychiatry entanglement, which may warrant intensive intervention, including hospital admission and antipsychotic treatment. Treatment options include an early recognition, managing underlying neuropsychiatric disorders, psycho education, cognitive psychotherapy, and choosing an effective psychopharmacological agent. The management strategy may also resort to a geographical intervention, i.e. separation between both persons to complement the biological treatment.

Keywords: Pathological jealousy, green eyed monster, pharmacological and geographical perspective.

Shepherd M. Morbid jealousy: Some clinical and social aspects of a psychiatric symptom. Br J Psychiatry 1961; 107(449): 687-753.
Mullen PE, Ed. ed. editor Jealousy: The pathology of passion. 1991.
Kingham M, Gordon H. Aspects of morbid jealousy. Advances in Psychiatric Treatment 2004; 10(3): 207-15.
Company HMHP. American Heritage® Dictionary of the English Language. 5th ed. Houghton Mifflin Harcourt Publishing Company 2016.
Oxford English Dictionary Oxford University Press. 2016.
Daly M, Wilson M, Weghorst SJ. Male sexual jealousy. Ethol Sociobiol 1982; 3(1): 11-27.
Cobb JP, Marks IM. Morbid jealousy featuring as obsessive-compulsive neurosis: Treatment by behavioral psychotherapy. Br J Psychiatry 1979; 134(3): 301-5.
DeSteno D, Valdesolo P, Bartlett MY. Jealousy and the threatened self: getting to the heart of the green-eyed monster. J Pers Soc Psychol 2006; 91(4): 626-41.
Ecker W. Non-delusional pathological jealousy as an obsessive-compulsive spectrum disorder: Cognitive-behavioural conceptualization and some treatment suggestions. J Obsessive Compuls Relat Disord 2012; 1(3): 203-10.
Jealousy PVS. Jealousy. London: Penguin; 1988.
Soyka M, Schmidt P. Prevalence of delusional jealousy in psychiatric disorders. J Forensic Sci 2011; 56(2): 450-2.
Michael A, Mirza S, Mirza KAH, Babu VS, Vithayathil E. Morbid jealousy in alcoholism. Br J Psychiatry 1995; 167: 668-72.
Poletti M, Perugi G, Logi C, et al. Dopamine agonists and delusional jealousy in Parkinson’s disease: A cross-sectional prevalence study. Mov Disord 2012; 27(13): 1679-82.
W. S. Four tragedies: Hamlet, Othello, King Lear, Macbeth: Bantam books 1988.
Todd J, Dewhurst K. The Othello syndrome; a study in the psychopathology of sexual jealousy. J Nerv Ment Dis 1955; 122(4): 367-74.
Vauhkonen K. On the pathogenesis of morbid jealousy with special reference to the personality traits of an interaction between jealous patients and their spouses. Acta Psychiatr Scand Suppl 1968; 202: 2-261.
Soyka M, Naber G, Volcker A. Prevalence of delusional jealousy in different psychiatric disorders. An analysis of 93 cases. Br J Psychiatry 1991; 158: 549-53.
DeSteno Da SaloveyP. Jealousy and the characteristics of one’s rival: A self-evaluation maintenance perspective. Personality and Social Psychology Bulletin 1996; 22(9): 920-32.
A. T. Advances in experimental social psychology: Elsevier Inc; 1988 Dec 31. 181-227 p.
Seidenberg R. Jealousy; the wish. Psychoanal Rev 1952; 39(4): 345-53.
Batinic B, Duisin D, Barisic J. Obsessive versus delusional jealousy. Psychiatr Danub 2013; 25(3): 334-9.
Easton JA, Schipper LD, Shackelford TK. Morbid jealousy from an evolutionary psychological perspective. Evol Hum Behav 2007; 28(6): 399-402.
Seeman MV. Pathological Jealousy: An interactive condition. Psychiatry 2016; 79(4): 379-88.
Tarrier N, Beckett R, Harwood S, Bishay N. Morbid jealousy: a review and cognitive-behavioural formulation. Br J Psychiatry 1990; 157: 319-26.
Enoch MDT, W.H. Uncommon Psychiatric Syndromes. Second ed: Bristol: John Wright; 1979.
Miller MA, Kummerow AM, Mgutshini T. Othello syndrom preventing a tragedy when treating patients with delusional disorders. J Psychosoc Nurs Ment Health Serv 2010; 48(8): 20-7.
Poletti M, Lucetti C, Baldacci F, Del Dotto P, Bonuccelli U. Concomitant development of hypersexuality and delusional jealousy in patients with Parkinson’s disease: a case series. Parkinsonism Relat Disord 2014; 20(11): 1290-2.
Rocha S, Pinho J, Ferreira C, Machado A. Othello syndrome after cerebrovascular infarction. J Neuropsychiatry Clin Neurosci 2014; 26(3): E1-2.
Hsiao CP, Tzeng NS, Juan CJ, Ma SI. Othello syndrome in a patient with right orbitofrontal lobe cavernous sinus hemorrhage. J Neuropsychiatry Clin Neurosci 2013; 25(3): E14-5.
Kuruppuarachchi KA, Seneviratne AN. Organic causation of morbid jealousy. Asian J Psychiatr 2011; 4(4): 258-60.
Graff-Radford J, Whitwell JL, Geda YE, Josephs KA. Clinical and imaging features of Othello’s syndrome. Eur J Neurol 2012; 19(1): 38-46.
Charlton BG, McClelland HA. Theory of mind and the delusional disorders. J Nerv Ment Dis 1999; 187(6): 380-3.
Bechara A, Damasio H, Damasio AR. Emotion, decision making and the orbitofrontal cortex. Cereb Cortex 2000; 10(3): 295-307.
Shrestha K, Rees DW, Rix KJB, Hore BD, Faragher EB. Sexual jealousy in alcoholics. Acta Psychiatr Scand 1985; 72(3): 283-90.
Diane M. Morbid jealousy: The green-eyed monster. Irish Journal of Psychological Medicine 2010; 27(2): 1-7.
Camicioli R. Othello syndrome-at the interface of neurology and psychiatry. Nat Rev Neurol 2011; 7(9): 477-8.
Robbins TWEB. Neurobehavioural mechanisms of reward and motivation. Curr Opin Neurobiol 1996; 6(2): 228-36.
Schultz W, Dayan P, Montague PR. A neural substrate of prediction and reward. Science 1997; 275(5306): 1593-9.
Pessiglione M, Seymour B, Flandin G, Dolan RJ, Frith CD. Dopamine-dependent prediction errors underpin reward-seeking behaviour in humans. Nature 2006; 442(7106): 1042-5.
Cheung P, Schweitzer I, Crowley K, Tuckwell V. Violence in schizophrenia: role of hallucinations and delusions. Schizophr Res 1997; 26(2-3): 181-90.
Nagy H, Levy-Gigi E, Somlai Z, Takats A, Bereczki D, Keri S. The effect of dopamine agonists on adaptive and aberrant salience in Parkinson’s disease. Neuropsychopharmacology 2012; 37(4): 950-8.
Kapur S. Psychosis as a state of aberrant salience: A framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 2003; 160(1): 13-23.
Miller R. Schizophrenic psychology, associative learning and the role of forebrain dopamine. Med Hypotheses 1976; 2(5): 203-11.
Roy M, Shohamy D, Wager TD. Ventromedial prefrontal-subcortical systems and the generation of affective meaning. Trends Cogn Sci 2012; 16(3): 147-56.
Marazziti D, Poletti M, Dell’Osso L, Baroni S, Bonuccelli U. Prefrontal cortex, dopamine, and jealousy endophenotype. CNS Spectr 2013; 18(1): 6-14.
Mullen PE PM, Purcell R. Stalkers and their victims: Cambridge University Press; 2000 Apr 27.
Leong GB, Silva JA, Garza-Trevino ES, et al. The dangerousness of persons with the Othello syndrome. J Forensic Sci 1994; 39(6): 1445-54.
Marzuk PM, Tardiff K, Hirsch CS. The epidemiology of murder-suicide. JAMA 1992; 267(23): 3179-83.
Silva JA, Leong GB, Weinstock R. The dangerousness of persons with misidentification syndromes. Bull Am Acad Psychiatry Law 1992; 20(1): 77-86.
Bennett MR, Hacker PMS. Criminal Law as It Pertains to Patients Suffering from Psychiatric Diseases. J Bioeth Inq 2011; 8(1): 45-58.
Roudsari MJ, Chun J, Manschreck TC. Current treatments for delusional disorder. Curr Treat Options Psychiatry 2015; 1(2): 151-67.
Mooney HB. Pathologic jealousy and psychochemotherapy. Br J Psychiatry 1965; 111(480): 1023-42.
Byrne A, Yatham LN. Pimozide in pathological jealousy. Br J Psychiatry 1989; 155: 249-51.
González-Rodríguez A, Catalán R, Penadés R, et al. Antipsychotic response in delusional disorder and schizophrenia: a prospective cohort study. Actas Esp Psiquiatr 2016; 44(4): 125-35.
Cannas A, Solla P, Floris G, Tacconi P, Marrosu F, Marrosu MG. Othello syndrome in parkinson disease patients without dementia. Neurologist 2009; 15(1): 34-6.
Brune M, Gerlach G, Schroder SG. [A case of delusional jealousy in Parkinson disease ]. Nervenarzt 2001; 72(3): 224-6.
Cipriani G, Vedovello M, Nuti A, di Fiorino A. Dangerous passion: Othello syndrome and dementia. Psychiatry Clin Neurosci 2012; 66(6): 467-73.
Fahmi Hassan F. Paranoid delusions: A review of theoretical explanations. ASEAN J PSychiatry 2011; 12(1): 102-10.
Kellett S, Totterdell P. Taming the green-eyed monster: Temporal responsivity to cognitive behavioural and cognitive analytic therapy for morbid jealousy. Psychol Psychother 2013; 86(1): 52-69.
Langfeldt G. The erotic jealousy syndrome. A clinical study. Acta Psychiatr Scand Suppl 1961; 36(151): 7-68.
Violence RCoPD. Report of the Domestic Violence Working Group (Council Report CR102). London: Royal College of Psychiatrists.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Page: [201 - 209]
Pages: 9
DOI: 10.2174/1389450118666170704142708
Price: $65

Article Metrics

PDF: 43