Idiopathic restless legs syndrome and psychoses

There are no previous reports concerning comorbidity of psychosis and idiopathic familial restless legs syndrome (RLS). In the psychiatric literature the concept ''Ekbom's syndrome'' has been equated with delusions of parasitosis and not to a paresthetic, organic disorder. Psychotic patients invariably receive the diagnosis of akathisia. We report a family with genetic disposition to idiopathic RLS and psychotic illness. Excellent short-term treatment effect of tramadol for idiopathic RLS is reported for the first time. Four-limb actometry, a novel method for diagnosing and measuring RLS and akathisia, is described. We suggest that the relationship of RLS, psychosis, and idiopathic or drug-induced akathisia has been obscured by nosologic difficulties. RLS should be considered a diagnosis and treated even among psychotic patients, although it may be rare. Tramadol may be useful in short-term treatment of RLS.