Importance of Capgras syndrome in shared psychotic disorder: a case report.

Shared psychotic disorder characterized by Capgras syndrome is an extremely rare condition. To our knowledge, there are only a few published papers on this condition. This paper presents a case of shared Capgras syndrome in two sisters. The inducer was a younger sister with schizophrenia, who passed on her Capgras delusion to her older sister after the death of their father. After committing a violent offense caused by Capgras delusion, a court ordered the sisters' involuntary admission to a psychiatric hospital. After being separated and receiving antipsychotic treatment, the sisters showed substantial improvement. However, shortly after hospital discharge, they stopped taking their medication and disappeared. After 15 years, their mother died and shortly afterwards, the sisters were re-admitted for forensic psychiatric evaluation after another violent crime caused by Capgras delusion. Timely recognition, adequate treatment and maintaining a therapeutic alliance could contribute to a better clinical course and outcome of this disorder, and reduce the risk of violent behavior.

A Longitudinal Case of Shared Delusional Infestation.

Delusional infestation disorders are characterized by fixed but false beliefs about infection by a parasite, insect, or other living organism. Shared psychotic disorders are characterized by a single delusion instigated by a "primary" index patient and then induced in one or more "secondary" persons. We describe a case report of shared delusional infestation among an index patient and two family members that generated many healthcare encounters over the course of 12-15 months. This case report highlights the challenges in diagnosing and treating these conditions in the Emergency Department setting and their disproportionate utilization of healthcare resources. We discuss risk factors and characteristics of delusional infestations and shared psychotic disorders, as well as best practices to approach diagnosis, treatment, and disposition in the Emergency Department.

The plague: a case of delusional infestation with folie à deux / A praga: um caso de delírio de infestação com folie à deux

Folie à deux or Shared psychotic disorder (SPD) is a rare condition characterized by shared psychotic symptoms between two or more individuals. Delusional parasitosis (DP) is an uncommon psychiatric illness in that patients believe they are infested by insects, without evidence to support this belief. DP occurs in 5­15% of SPD. We report a case of cutaneous DP with SPD between an elderly mother and a daughter that lived together and withdrew from other social contacts for the last three years. We aim to highlight the relationship between SPD and DP, its prognosis, and clinical implications.

Folie à deux ou Perturbação Psicótica Compartilhada (PPC) é uma condição rara caracterizada por sintomas psicóticos compartilhados entre dois ou mais indivíduos. O delírio parasitário (DP) é uma doença psiquiátrica incomum em que os pacientes acreditam estar infestados por insetos, sem evidências que sustentem essa crença. O DP ocorre em 5 a 15% das PPC. Relatamos um caso de um DP cutâneo com PPC entre uma mãe idosa e uma filha que viviam juntas e afastadas de outros contatos sociais nos últimos três anos. O nosso objetivo é destacar a relação entre PPC e o DP, o seu prognóstico e implicações clínicas

Pseudocyesis Leading to Folie-à-Deux.

Pseudocyesis or false belief of pregnancy is the emergence of classical manifestations of pregnancy-nausea, breast enlargement and pigmentation, abdominal distention, amenorrhea, and labor pains-in a nonpregnant woman. It is a multifactorial disease and its development is influenced by many different elements such as neuroendocrine, social, psychodynamic, and cultural issues. "Folie-à-deux," is shared psychotic disorder, describes a syndrome in which delusion is transferred to another person who is more susceptible. Both individuals are closely related or know each other for a long time and typically live together in relative social isolation. In its commonest form, the individual who first develops the delusion (the primary case) is often chronically ill and typically is the dominant member in a close relationship with a more suggestible person (the secondary case) who also develops the delusion. Treatment options should also be kept in mind as antipsychotics themselves can increase prolactin levels and can lead to amenorrhoea and galactorrhea and can further strengthen patient's belief about her pregnancy. This case highlights that the most important therapeutic step in the treatment of folie-à-deux is separation of the inducer and the induced. Here we describe a case of folie-à-deux of a married couple in which the female had delusional pregnancy while the husband shared and supported her delusion against substantial medical evidence.

'Come share my world' of 'madness': a systematic review of clinical, diagnostic and therapeutic aspects of folie à deux.

Folie à deux, also known as shared psychotic disorder, shows intrinsic differences when compared to other psychiatric disorders. Literature about this condition is scanty and findings about its clinical correlates are not univocal. The present systematic review aimed at critically summarizing the existing evidence about folie à deux, also focussing on psychopathological, diagnostic and treatment features. The electronic databases PUBMED, Web of Science and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles reporting original data about socio-demographic, aetiological, clinical, diagnostic and treatment features of folie à deux, providing information about both primaries and secondaries, were included. Risk of bias was evaluated using the Critical Appraisal Skills Programme (CASP) instruments. The initial search yielded 834 records. After the screening process only 9 papers were deemed eligible for inclusion in the review. Folie à deux emerged to be a heterogeneous condition with a complex etiopathogenesis. The clinical presentation of the disorder included a multi-facet aspect, going beyond the classical description mainly focussed on delusions and possibly explaining conflicting outcomes of different treatments. Diagnostic categories appear to be often reductive and the need for a dimensional approach capable of global reliability emerged.

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.

[Folie à deux, symptoms sharing us a relationship modality: a case report]. / Folie à deux ou le partage de symptômes comme modalité relationnelle: à propos d'un cas.

Shared Psychotic Disorder or Folie à deux is a rare and controversial entity that raises phenomenological, nosographic and psychopathological issues. It questions the nature of dilusion and its occurrence outside the psychotic structure and also the issue of symptoms contagion in psychiatry. We offer a semiological analysis of an intrafamilial case of Folie à deux, a case with the clinical specificity of sharing not only delusional symptoms but also non-delusional psychotic elements. We then dig back in the epidemiological characteristics and common factors to other reported cases in the literature of different cultures. Then we draw a history of the entity and its evolution over the classifications since its first description by Legrand to the DSM 5. From here, we emphasize the insufficiency of a purely descriptive approach and focus on the possible link with other more common clinical situations of mental symptoms transmission between two or more persons. Then, we propose a psychopathological reflection that essentially targets the sharing of the symptom rather than its nature while questioning the function of the delusion in a delusional couple.

Shared psychotic disorder in children and young people: a systematic review.

This study aimed at searching the literature and reassessing the concept of shared psychotic disorder (SPD) in young people under 18 taking into account genetic vulnerability, social circumstances and family situation to have a better understanding of this condition. Published case reports from 1980 through to March 2017, which included children and adolescents meeting DSM-III/IV/IV-TR or ICD 10 criteria of SPD, were identified. Sociodemographic and clinical variables were collected and analysed; a post hoc analysis comparing inductors and induced was also conducted. Four hundred and eight articles were assessed for eligibility of which 27 were included in the qualitative and quantitative synthesis. Thirty families were described. Forty-eight children were identified including 6 inductors and 42 induced. Although delusional beliefs were presented in all subjects, hallucinations were only reported in 50% of the inductors and 27% of the inductees. Social isolation was the most common social context (83.3% of the inductors; 76.2% of the induced) and 18 out of 45 children (data missing for n = 3) were initially separated from adults involved although the outcome of the symptoms was not different from those who were not separated. Children who were inductors were more likely to meet criteria of major psychotic illness in the future. Most of the induced children involved in a case of shared psychosis were first-degree relatives of the inductor. Shared psychotic disorder probably occurs in premorbid predisposed individuals where genetic and environmental factors play an important role in the development of the psychotic episode.

A case of Capgras syndrome and folie à duex in monozygotic twins.

Both Capgras syndrome and folie à deux (insanity of two) are rare and fascinating psychopathological syndromes. Their etiology and the nosological position remain unclear. We present a case of substance-induced Capgras syndrome emerging as folie à deux (insanity of two) in monozygotic twins with strongly overlapping life histories. Then, we discuss the etiology and the nosological position of these two conditions as well as their significance for understanding the concept of psychosis.

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.

Shared Psychotic Disorder and the Killing of a Policeman: Barbieri v R [2016] NSWCCA 295.

By December 2012, 19-year-old Mitchell Barbieri had adopted the persecutory delusions of his mother when he stabbed to death a police officer. Initially, both mother and son were charged with murder. After declining to accept his plea of guilty to manslaughter on the basis of 'substantial impairment', the prosecution offered the concession that Barbieri had a 'significant cognitive impairment' and that the usual mandatory life sentence for killing a policeman did not apply. Subsequently, both Barbieri and his mother pleaded guilty to a number of serious offences and were sentenced to quite disparate terms of imprisonment. The commentary examines the unique cases of a mother and son who had a shared psychotic disorder and whose charges arose from the same facts and circumstances but whose convictions attracted markedly dissimilar sentences. The relevant sentencing principles derived from recent case authority are considered and the reasoning of the sentencing judge is contrasted with the reasoning of the NSW Court of Appeal, which allowed an appeal from Mr Barbieri's original sentence.

Folie à deux (transtorno delirante induzido) / Folie à deux (induced delusional disorder)

RESUMO Folie à deux, ou transtorno delirante induzido, é uma síndrome rara caracterizada por transferência de delírios de um sujeito considerado primariamente psicótico para um ou mais sujeitos considerados secundários em relação à origem do delírio. Apesar de ser um diagnóstico considerado raro, e até por isso esquecido nos tratados psiquiátricos atuais, nosso artigo descreve um caso de folie à deux entre mãe (sujeito delirante primário) e filha (paciente previamente saudável e secundariamente psicótica) que teve sucesso terapêutico e evolução muito favorável. Apesar de nosso caso ter tido evolução favorável, há relatos na literatura de desfechos trágicos como infanticídio. Além disso, nosso artigo chama atenção para alguns aspectos importantes. Primeiro, quadros de folie à deux podem ocorrer em muitas situações, e não só em confinamentos, diferentemente do que os sistemas classificatórios atuais tendem a fazer. Igualmente, não são tão raros como se supõe. Por último, os clínicos devem estar atentos a possíveis problemas psiquiátricos não reconhecidos no indivíduo considerado secundário.

ABSTRACT Folie à deux, or induced delusional disorder, is a rare syndrome characterized by transfer of delusions from a primary subject to one or more secondary subjects. Though a diagnosis considered rare and even so forgotten in current psychiatric treated our article describes a case of folie à deux between mother (primary delusional subject) and daughter (previously healthy and secondary psychotic subject) had therapeutic success and evolution very favorable. Although our case had favorable development, there are reports in the literature tragic outcomes as infanticide. In addition, our article draws attention to some important aspects. First, folie à deux frames can occur in many situations and not only in feedlots, unlike the current classification systems tend to do. Also, they are not as rare as it is supposed. Finally, clinicians should be alert to possible psychiatric problems not recognized in the individual considered secondary.

Folie a Deux.

Shared psychotic disorder is a rare psychiatric disorder. It is defined when a primary psychotic person imposes his/her delusional beliefs to the other person usually in a close relationship. Occurrence of this disorder among family members and close friends has been described. However, its exact incidence and prevalence is not known. Since such case has not been reported in Nepal to best of our knowledge, we present a case of shared delusional disorder along with brief review of literature. This case report describes a case of common shared persecutory delusion in husband and wife.

Folie a trois: atypical presentation as shared transient psychotic episode.

Shared psychotic disorder or induced delusional disorder can occur in different clinical settings and profile and is not uncommon. A case of Folie a trois with atypical clinical presentation as shared acute transient episode in a bereavement setting is reported. Suggestibility, close association and intimacy of the affected persons and major stress as psychological trigger act as psychopathological factors.

Shared psychotic manic syndrome in monozygotic twins: a case report.

OBJECTIVE: A rare phenomenon of Shared Psychosis Disorder occurring in the context of Bipolar I Disorder, in identical twins is reported. CASE PRESENTATION: Two identical twins with shared Psychotic Manic Syndrome were admitted and received antipsychotic and lithium as their treatment. Psychotic symptoms of primary case did not improve and her diagnosis changed into Schizophrenia. They had hypothyroidism at the same time. CONCLUSION: Completely shared manic syndrome along with the psychotic features shows a need for the criteria of shared syndromes to develop, including both psychotic and mood symptoms.

Folie a famille.

Shared psychotic disorder is often read as case report but not studied in length and rarely looked at in common clinical practice in psychiatry. Only a small percentage of cases involve families. Folie a famille is characterized as a shared psychotic disorder within a family in more than two members. The involved patients have an unusually close relationship and are isolated from others. We describe here a case of folie a famille involving a nuclear family consisting of the husband, the wife, and their three children. The primary patient was suffering from paranoid schizophrenia with prominent delusions of persecution that were imposed upon and later shared by his family. Temporary separation decreased the intensity of shared delusions in the other family members.

Folie à deux.

Folie à deux is defined as an identical or similar mental disorder affecting two or more individuals, usually the members of a close family. Two case reports of this condition are presented with a brief review of the literature. Prompt recognition of this condition is an essential step in the management. The majority of patients with folie à deux require multiple treatments including separation, antipsychotics, individual and group psychotherapy, and family therapy.