Folie a Deux: Shared Psychotic Disorder in a Medical Unit

Introduction. A shared psychotic disorder is a system of delusions shared by two or more individuals. Shared psychotic disorders typically develop in pairs or groups with a close relationship who are socially isolated. The function and affect of those inflicted with shared psychotic disorders usually remain intact. For these reasons, a shared psychotic disorder is seldom identified, diagnosed, and treated. This case describes a shared psychotic disorder incidentally discovered in a medical unit. Case. The patient was a 47-year-old woman with no known past psychiatric history who had been medically admitted for gastroenteritis. On the day of discharge, a psychiatric consult was requested for “paranoia and bizarre behavior.” The patient was seen making statements that she needed security and the FBI to escort her as she left the hospital. Another person in the patient’s room was discovered to be the patient’s mother who had been staying with her in the hospital. Evaluation of the patient along with observation of her mother revealed that the two shared a complex system of delusions revealing a diagnosis of shared psychotic disorder. Discussion. A shared psychotic disorder is a unique psychiatric diagnosis. It may be even rarer to diagnose in the inpatient medical setting because multiple individuals from a shared system are typically not seen. In this case, the patient and her mother had multiple clinical characteristics of a shared psychotic disorder, including an enmeshed relationship and social isolation. The treatment for shared psychotic disorders involves separation of the individuals and pharmacotherapy with antipsychotics. This case also presented a unique ethical dilemma as the psychiatric team was called to evaluate a patient and found a patient and another individual to have symptoms. Conclusion. A shared psychotic disorder is important to consider on the differential when cases of psychosis with delusional systems are seen on medical floors.

Shared Psychotic Disorder (Folie À Deux): A Rare Case with Dissociative Trance Disorder That Can Be Induced

BACKGROUND: Shared psychotic disorder was first introduced in the 19th century in France with the name Folie à deux. Since then, the concept of Folie à deux has been developed and produces several subtypes in France. In DSM, this disorder is called Shared Psychotic Disorder, and in ICD-10, it is called Induced Delusional Disorder. However, some of the classic subtypes of Folie à deux are not included in the above categories. CASE REPORT: We found a case of shared psychotic disorder between a 38-year-old male inducer, a Batak tribe with two female recipients, 34 and 36 years from the Batak tribe. They were found to share the same delusions and hallucinations, and inducers could make recipients into trance conditions. These three individuals did not get along with the surrounding community and often carried out activities and perform rituals together. CONCLUSION: Overall, our case has some unique features of folie à deux. In this case, there is a trance condition that can be induced that have not been reported in the literature or case reports related to Folie à deux.

‘Everybody’s Somebody’s Fool’: Folie à Deux in Shakespeare’s Love Duets

Of the myriad versions of face-to-faceness in Shakespeare, an elementary case is what this paper calls the “love duet.” Lawrence Manley’s contribution pursues a formal and dramaturgical route into the broader problem of Shakespeare’s ways of depicting and understanding couples by focusing on a specific instance of the love duet in the earlier work of Shakespeare. The “unchaperoned duet” is a scene or portion of a scene in which the absence of third parties is a theatrical pre-condition and a token for the absence of inhibitions to erotic face-to-face encounter. The paper also considers the impact of inhibiting factors (such as separation, absence, the presence of other characters, impinging circumstance, and erotic betrayal) on the duet. Examples are set against both early modern contexts (ancient literature, Renaissance theories of sympathy, and the development of musical duets) and modern theories, including Beckerman’s taxonomy of duets types, J. L Austin’s speech-act theory, and the clinical diagnosis of “Shared Psychotic Disorder (folie à deux)”(DSM-IV) or “delusional symptoms in partner of individual with delusional disorder” (DSM-V).

Criminal couples. From ‘madness shared by two’ to the mental illness: A review of brutal crimes

The criminal couple is an uncommon phenomenon, since criminals act alone or involving other individuals in a fortuitous manner. The murders committed in pairs represent a rather rare eventuality (it is estimated that in Italy they are about 5%). At the base of this very particular dynamic there is the c.d. folie à deux, otherwise indicated in the psychiatric nosography as “Shared Psychotic Disorder” and ICD-10 as “Induced Delusional Disorder”. Described for the first time in 1887 by Lasègue and Falret, it is characterized by the appearance of a delirium in a subject called the Primary Case, shared by the induced subject. The delusional couple lives in close correlation and at the same time isolated from the social context, conditions that facilitate the influence of the incube, bearer of a more serious mental pathology, on the succubus not necessarily affected by a psychotic pathology, nor, by force coming from a criminal subculture. The succubus therefore welcomes the delirious ideas of the incube and makes them its own, giving life not to the simple sum of two individuals but to a quid novi represented by the couple, united by a very strong pathological dependence. This contribution aims to highlight, through the analysis of some famous homicidal couples, the recognition or otherwise of the perpetrators of crimes, a total or partial defect of mind and the consequent imputability not omitting considerations on the social reintegration of them; once the prison sentence has been expiated.

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.