Morbid jealousy and erotomania

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Red flags

• Partner or family reports escalating accusations, surveillance, weapons access, or fear of assault — treat as dynamic high risk until safety secured
• Delusional jealousy with prior intimate-partner violence, alcohol intoxication, and refusal of separation — homicide and homicide-suicide pathway concern
• Erotomanic fixation on a clinician, public figure, or neighbour with approach behaviour, gifts, or threats to 'rivals' — boundary, security, and multi-agency plan
• Late-onset Othello picture with cognitive decline or new dopamine-agonist therapy — urgent organic and medication review
• Couples therapy requested while active delusion and violence risk are untreated — do not collude; prioritise victim safety
• Court report requested after assault without multi-source brief — do not equate diagnosis with mental-impairment defence