Reversal of roles in folie à deux associated with manic-depressive illness

1992 ◽  
Vol 9 (1) ◽  
pp. 55-57 ◽  
Author(s):  
C M Dympna Ryan ◽  
Shaukat A Khan ◽  
Hilary M C Warwick ◽  
Richard H S Mindham

AbstractAn example of folie à deux with an uncommon clinical picture is presented. It concerns two spinster sisters, with no past psychiatric history, who became simultaneously manic while on holiday. The “Principal” was clearly deluded; the “Associate” shared these abnormal beliefs. After recovery and eighteen months later, one became depressed and the other shared her suicidal ideas, but this time the roles of the “Principal” and “Associate” were reversed. The shortcomings of the ICD10 and DSM-IIIR in classifying this syndrome are highlighted.

1986 ◽  
Vol 16 (2) ◽  
pp. 331-335 ◽  
Author(s):  
Russell T. Joffe ◽  
Robert M. Post ◽  
Thomas W. Uhde

SynopsisThe effects on serum electrolytes of carbamazepine, an acute and prophylactic treatment for manic-depressive illness, were assessed in subjects with primary affective disorder. Carbamazepine caused statistically significant, but clinically insubstantial, reductions in serum sodium and calcium, but not in the other electrolytes measured. Decreases in serum sodium and calcium were not related to carbamazepine dose, blood levels, or the degree of clinical improvement. The theoretical implications of these findings are discussed.


Author(s):  
James Hopkins

The basic concepts of psychoanalysis are due to Sigmund Freud. After establishing psychoanalysis Freud worked in Vienna until he and other analysts fled the Nazi occupation. Post-Freudian psychoanalysis has evolved in distinct ways in different countries, often in response to influential analysts who settled there. Freud’s patients were mainly adults who suffered from neurotic rather than psychotic disturbances. He found their psychological difficulties to be rooted in conflict between love and hate, caused by very disparate, often fantastic, images deriving from the same parental figure. These images provided the basic representations of the self and others, formed by processes of projection (representing the other via images from the self) and introjection (representing the self via images from the other). The internalized image of a parent could be used to represent the self as related to some version of the other, as in the formation of the punitive super-ego, or as like the other, as in the identification with the parent of the same sex through which the Oedipus complex was dissolved. Later analysts, including Anna Freud and Melanie Klein, observed that the uninhibited play of children could be seen to express fantasies involving such images, often with striking clarity. This made it possible to analyse children, and to see that their representations of the self were regularly coordinated with fantastic representations of others, with both organized into systematically interacting systems of good and bad. Emotional disturbance was marked by a fantasy world in which the self and idealized good figures engaged in conflict with hateful bad objects, unmitigated by any sense that all derived from the same self and parental figures. Such observations made it possible to confirm, revise and extend Freud’s theories. Klein saw that symptoms, character and personality could be understood in terms of relations to internalized fantasy-figures, laid down in early childhood; and this extended to psychotic disturbances, such as schizophrenia and manic-depressive illness, which turned on the particular nature of the figures involved. This gave rise to the British object-relations approach to psychoanalysis. It also influenced the development of ego-psychology and self-psychology by Hartmann, Kohut and others in the United States, and Lacan’s attempt to relate psychoanalysis to language, in France.


1986 ◽  
Vol 149 (2) ◽  
pp. 191-201 ◽  
Author(s):  
Robert M. Post ◽  
David R. Rubinow ◽  
James C. Ballenger

Few biological theories of manic-depressive illness have focused on the longitudinal course of affective dysfunction and the mechanisms underlying its often recurrent and progressive course. The authors discuss two models for the development of progressive behavioural dysfunction—behavioural sensitisation and electrophysiological kindling—as they provide clues to important clinical and biological variables relevant to sensitisation in affective illness. The role of environmental context and conditioning in mediating behavioural and biochemical aspects of this sensitisation is emphasised. The sensitisation models provide a conceptual approach to previously inexplicable clinical phenomena in the longitudinal course of affective illness and may provide a bridge between psychoanalytic/psychosocial and neurobiological formulations of manic-depressive illness.


JAMA ◽  
1973 ◽  
Vol 224 (8) ◽  
pp. 1187 ◽  
Author(s):  
Julien Mendlewicz

1995 ◽  
Vol 60 (5) ◽  
pp. 434-435 ◽  
Author(s):  
Rosa Puertollano ◽  
Gillermo Visedo ◽  
Jerónimo Saiz-Ruiz ◽  
Consuelo Llinares ◽  
José Fernández-Piqueras

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