Aspects of morbid jealousy

Morbid jealousy is encountered in general, old age and forensic psychiatry, and clinicians in each specialty should be familiar with its recognition and management. As well as clinical matters, the issue of risk to the patient and others is prominent in the consideration of morbid jealousy. Hospitalisation is sometimes required, the use of compulsory admission is not infrequent and treatment in secure settings is occasionally warranted. This review addresses the nature of morbid jealousy, its psychopathology, diagnostic issues, associations, risks and management.

Jealousy is a common, complex, ‘normal’ emotion. The Oxford English Dictionary defines the word jealous as ‘feeling or showing resentment towards a person one thinks of as a rival’. This definition indicates that it is the belief in the presence of rivalry that is the key issue, and that whether or not such a rivalry truly exists is less important. Jealousy within a sexual relationship has clear advantages in evolutionary terms: behaviour that ensures the absolute sole possession of a partner allows the propagation of one’s own genes at the expense of those of a true rival (Daly et al, 1982). However, when the belief in rivalry is mistaken, much time and effort may be wasted in attempting to eliminate a false threat.

Morbid jealousy describes a range of irrational thoughts and emotions, together with associated unacceptable or extreme behaviour, in which the dominant theme is a preoccupation with a partner’s sexual unfaithfulness based on unfounded evidence (Cobb, 1979). It is noteworthy that individuals may suffer from morbid jealousy even when their partner is being unfaithful, provided that the evidence that they cite for unfaithfulness is incorrect and the response to such evidence on the part of the accuser is excessive or irrational. Healthy people become jealous only in response to firm evidence, are prepared to modify their beliefs and reactions as new information becomes available, and perceive a single rival. In contrast, morbidly jealous individuals interpret conclusive evidence of infidelity from irrelevant occurrences, refuse to change their beliefs even in the face of conflicting information, and tend to accuse the partner of infidelity with many others (Vauhkonen, 1968).

In popular usage, morbid jealousy has been dubbed the ‘Othello syndrome’, with reference to the irrational jealousy of Shakespeare’s Othello (Todd & Dewhurst, 1955). This is misleading, as it suggests that morbid jealousy is a unitary syndrome. Demonstrably, this is not the case, and morbid jealousy should be considered to be a descriptive term for the result of a number of psychopathologies within separate psychiatric diagnoses (Shepherd, 1961)