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Treatment for this disorder gains the best results when tailored specifically for each individual. Sigmund Freud explained erotomania as a defense mechanism to ward off homosexual impulses which can lead to strong feelings of paranoia, denial, displacement and projection. These individuals are usually timid, dependent women that are often sexually inexperienced. Erotomania is listed in the DSM-5 as a subtype of a delusional disorder. The man had sent hundreds of "strange and offensive" packages to Queen Elizabeth II over the previous 15 years. Similarly, it has been explained as a way to cope with severe loneliness or ego deficit following a major loss.

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