A Contagious Disorder: Folie à Deux and Dementia

Background: Folie à deux is a clinical condition that was first described in 19th century. It is a psychotic disorder in which two closely associated individuals share a similar delusional system. Objectives: The aim of this article is to review the nosological significance of folie à deux and to explore the disorder among patients with dementia. Methods: Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published before 2017. Search terms used included dementia, folie à deux, induced delusional disorder, neurocognitive disorders, shared psychotic disorder. Publications found through this indexed search were reviewed for further relevant references. Results and Conclusion: Cases of Folie à deux involving patients with dementia are reported quite infrequently. Most of the studies on the topic consist in case reports. Clinicians are obliged to treat the disorder. They should be alert to the potential high risk inherent this psychotic syndrome.

Religiousness in First-Episode Psychosis

The aim of the present study is to explore the significance of religiousness for patients suffering from first-episode psychosis. Our study is a thematic analysis. The study illustrates how the patients understood their hallucinations as mystical experiences. Even so, many of the patients describe their religiousness to be helpful in coping with their disorder, giving meaning to life as well as a relationship to a sacred figure. However, their religiousness often contained religious omnipotent delusions, and built on hallucinations, displayed an unsecure relationship to the sacred figure. From a psychiatric point of view, the misinterpretation of hallucinations as mystical experiences may reinforce their delusional system and cause an obstacle to recovery. This misinterpretation may also cause problems for patients’ religious coping. Our findings underline the importance of taking patients’ religiousness into account in psychotherapy.

Folie à Deux: Shared or “Infected” Madness? About a Case Report

The shared madness or Folie à deux was described in France in the nineteenth century by Charles Lasage and Pierre Falret, as a condition where a person (the primary) builds a delusional system, sharing it with another (the secondary), who must be very close to the first affected, becoming delirious with the same subject. Several theories attempt to explain the phenomenon that challenges theories of personality structures, rooted in relational and/or environmental features of psychosis. Theoretically, there are many attempts to classify this psychotic experien in some manuals they distinguish various types of partners: the simultaneous psychosis, where the two people start to became delirious at once; imposed psychosis, in which the disorder arises first with one, then going on to “healthy” individual and symptomatology disappears after being separated; and communicated psychosis, where the first transmitted the psychotic experience to the second, and he or she develops his or her own delusion not interrupted even while separated. Other classifications about shared madness not only between two people, but three, and four, even a whole family show us how complicated the delirium systems can become. In our paper, we will discuss the different theories explaining this rare psychiatric condition based on a case about two brothers of 35 and 37, who live together with the rest of the family, and also come together to the same mental health center, although with different psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risperidone and olanzapine in treatment of delusional disorders

Delusional disorders are severe psychotic disorders with characteristic non-bizarre delusions often organized in permanent delusional system.AimTo estimate efficacy of risperidone and olanzapine in treatment of DD.Methods135 patients with DD were divided into Haloperidol-control (41), Risperidone (49) and Olanzapine group (45 patients). Patients were observed for 6 months according to protocol, which included PANSS Scale and CGI1-4 Scale. Control group was treated with haloperidol 5–30 mg/24 h. Experimental groups were treated with risperidone 2–6 mg/24 h and olanzapine 10–20 mg/24 h.ResultsPretrial PANSS score was 57.28 in risperidone(R), 60.47 in olanzapine(O) and 58.45 in control(H) group. PANSS score after 180 days was 34.32 in R, 35.58 in O and 37.97 in H group. There was no statistical difference in pretrial scores for PANSS (p = 0.691), CGI1 (p = 0.733), CGI2 (p = 1.000), and CGI3 (p = 1.000) scores. There was statistical significance in PANSS and CGI1-4 score reduction after 180 days in all groups (p = 0.000). There was no statistical difference in PANSS score reduction between R and H (p = 0.114) and O and H group (p = 0.136). CGI1-4 scores reduction: CGI1, Rvs.H, p = 0.019 and Ovs.H, p = 0.032 with high statistical significance; CGI2, Rvs.H, p = 0.153 and Ovs.H, p = 0.179 with no statistical significance; CGI3, Rvs.H, p = 0.183 and Ovs.H, p = 0.161 with no statistical significance; CGI4, Rvs.H, p = 0.000 and Ovs.H, p = 0.000 with high statistical significance. Adverse effects were significantly lower in Risperidone (21.42%) and Olanzapine (21.81%) than in Haloperidol (57.5%) group.ConclusionRisperidone and Olanzapine have slightly better efficacy in treatment of DD comparing to haloperidol, with statisticaly significant lower adverse effects rate.

Phenomenological Aspects of Monodelusional Disorders

The monodelusional disorders correspond closely to the Kraepelinian description of paranoia (Kraepelin, 1921), and to the DSM—III—R category of “delusional (paranoid) disorder” (American Psychiatric Association, 1987). The essential feature is a stable delusional system, and the encapsulated quality of the delusion is characteristic. The rest of the personality is notably well preserved, but the delusional system, despite its encapsulation, takes over much of the individual's way of life. There are profound and striking secondary changes in affect, attitude and logic when the patient switches from the normal to the delusional mode or vice versa.