A case series of shared delusional infestation: folie à deux revisited.

Delusional infestation describes the unshakeable belief that one's skin is infected or infested with an external organism or inanimate material, in the absence of supportive medical evidence. It is one of the most challenging psychodermatological conditions to manage, given the rigidity of patients' physically focused health beliefs, and the competing need to introduce antipsychotic therapy to bring about resolution. This is rendered exponentially more complex when partners or family members are similarly afflicted. This situation is known as shared delusional infestation, shared psychotic disorder (SPD), or folie à deux. We present a series of three couples with SPD who were referred to our tertiary psychodermatology service during the same year. On examining the literature we were intrigued to discover that subtly different subtypes of SPD have been recognized since the late 1800s. These include folie simultanée, imposée, communiquée and induite. Our cases neatly demonstrate three of these variants, and highlight the difficulties in facilitating effective treatment.

Delusional sharing: a history focus-on and case report of folie à deux.

Folie à deux (FAD) is a clinical condition that was first described by Lasègue and Falret in 19th century. They reported a rare condition where two or more people shared delusional ideas from a person to another. Nowadays a trace of this historical diagnosis and its theoretical framework, could be found on ICD-10 where FAD is translated in "Shared Psychotic Disorder". Given the lack of literature and a well-defined set of symptoms it is hard to detect the clinical limits of FAD. Furthermore, the complex of comorbidities could lead to a misdiagnosis. In this paper we report a peculiar case of FAD with an historical focus trying to give a wider point of view and tools to recognize this unconventional psychiatric diagnosis.

Folie a plusieurs: forensic cases from nineteenth-century Ireland.

Folie a plusieurs is a syndrome in which two or more individuals share symptoms (e.g., delusions). This paper uses archival material to present and discuss forensic psychiatric cases of folie a plusieurs from nineteenth-century Ireland. The cases of three brothers who all 'became insane at the same time' and killed another brother illustrate: the role of organic factors in folie a plusieurs; the use of 'moral management' strategies; and the problem of tuberculosis in asylums. The case of one woman whose family 'all became insane at once' and killed one of her sons illustrates: the importance of identifying the 'primary' patient; the difficulties experienced by 'secondary' cases; and the limited therapeutic progress achieved in nineteenth-century asylums. While further historical study is required to explain the emergence of the concept of folie a plusieurs in the late nineteenth century, it is clear that, over one hundred years since the term came to prominence, 'communicated insanity' still presents substantive diagnostic, clinical and ethical challenges to mental health and judicial services.

The diary of a madman, seventeenth-century style: Goodwin Wharton, MP and communer with the fairy world.

Goodwin Wharton (1653-1704) was a nobleman's son and a Whig MP who played no small part in English public life. His manuscript journal shows, however, that he also lived a bizarre secret life of the mind of a kind which, in later generations, would have led to his confinement as suffering from mental illness. Above all, through the offices of his medium and lover, Mary Parish, he entered into elaborate relations both with the fairy world and with God and His Angels. This paper examines our records of Wharton's consciousness.