[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 Obsessive-Compulsive Disorder: An Italian Case Report.

Shared obsessive-compulsive disorder (S-OCD) has seldom been reported in the literature, whereas shared psychotic disorder has been described since the end of 19th century. The aim of this report was to describe a case of S-OCD in a married couple. A 38-year-old OCD patient, after several pharmacological trials, eventually improved when a combination of escitalopram and risperidone was prescribed. During his symptoms' remission, his wife started developing the same OCD symptoms. She was prescribed escitalopram, but, given her inconsistent compliance, it was difficult to obtain full effectiveness of the pharmacological treatment. The case showed several common features with S-OCD. Obsessions and delusions could be considered as extremes of the same spectrum-an option recognized by the Diagnostic and statistical manual of mental disorders, fifth edition within the "OCD with poor insight" category-and S-OCD could represent the continuum between OCD and psychotic conditions. Additional investigation is required to better understand psychotic and nonpsychotic shared disorders.

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.

De Clérambault Syndrome, Othello Syndrome, Folie à Deux and Variants.

Non-bizarre delusion, defined as a false belief possible although highly unlikely, is the main manifestation of delusional disorders, previously known as paranoia. Based on the predominant delusional themes, 5 main subtypes may be described - erotomanic, grandiose, jealous, persecutory, and somatic. We present here 2 main delusional disorders, the De Clérambault syndrome and the Othello syndrome, and another closely related to the previous ones - Folie à deux. In the De Clérambault syndrome, the main delusional theme is erotomanic type, related to passional delirium where the patient has strong sexual feelings towards another person and has the belief that this other person is deeply in love with him or her. Patients with the Othello syndrome present a delusional disorder of jealous type, a pathological delusion that the partner is unfaithful. In Folie à deux, 2 individuals shared the same psychiatric symptom. However it may be variable, describing variants such as folie imposée or folie simultenée. The risk of aggressive behavior exists in these patients. Knowledge of these syndromes is essential to allow an accurate diagnosis and prompt treatment.

[A typical shared psychotic disorder: about a case]. / Trouble psychotique partagé atypique: à propos d'une observation.

Shared psychotic disorder is a rare entity characterized by the transmission of delusional symptoms from one patient ("inducer") to another ("induced" partner). We here report a clinical observation of atypical shared psychotic disorder involving delusion of persecution and of grandeur in a teenager induced by two subjects (grand-father and paternal uncle) with two different types of psychiatric disorders, all of which present in the same subject (third-party). The nature of the content transmitted to the third subject was the sum of the ideas of the first two subjects. These three subjects had a close relationship and lived in a closed environment, without access to the outside world.

Folie à deux and Fregoli syndrome with greater severity in the 'secondary' - A case report.

Folie à deux and Fregoli syndrome are rarely seen in clinical practice. We present a case in which these rare syndromes co-occur. Remarkably, in this case the 'secondary' develops a more serious illness course than the 'primary' and reciprocally induces a de novo Fregoli delusion in the 'primary'. This case discusses how socio-cultural factors, such as interdependent family dynamics, could have precipitated this rare variant of folie à deux. It also highlights the importance of making culturally-sensitive formulations for treatment.

All Alone Together: Case Report of Folie à Trois With Schizoaffective and Negative Symptoms in Monozygotic Triplets.

We present a case of folie à trois with schizoaffective and negative symptoms in monozygotic triplets, which to our knowledge is unique. For 4 years starting in their late teens, the 3 male siblings withdrew socially, adopted a primitive lifestyle, and exhibited poor self-care with increasing aggression, which led to their admission to the hospital at the age of 22 years. Over the subsequent 8 years, 1 brother recovered fully with treatment, resumed academic and social functioning, and does not need medication therapy currently. The other 2 brothers have disengaged from clinical care and moved back in together, following a socially isolated, disengaged way of life. They have relapsed gradually, displaying their previous symptomatology of suspiciousness, grandiosity, irritability, and affective flattening. This case demonstrates that shared psychosis can merge with endogenous psychopathology, including negative symptoms, in the context of genetic susceptibility. In closely associated individuals, such phenomena may go unnoticed or be misinterpreted, and therefore not receive appropriate management. In such a situation, separation as a part of the treatment plan should be approached gradually in combination with a therapy that emphasizes each patient as a separate individual.

Un caso de folie à trois / Folie à trois, a case

Un trastorno de ideas delirantes inducidas que afecte a tres o más personas no es frecuente. Presentamos un caso que afecta a tres miembros de una familia que desarrollaron un sistema delirante de perjuicio, analizando su tratamiento y evolución a corto plazo (AU)

Shared delusions of doubles.

This is the first report of two partners in a folie à deux situation manifesting identical Capgras delusions. It is postulated that the Capgras syndrome developed as a result of interaction between a dominant patient with primarily paranoid psychopathology and a submissive one with primarily organic dysfunction. The submissive "neuro-organic" partner experienced a non-delusional misidentification that acquired a delusional component and developed into the Capgras syndrome as a result of elaboration by the dominant paranoid partner, who subsequently "imposed" the Capgras delusion on the submissive partner. The submissive patient, and, to a lesser extent the dominant patient, had evidence of organic cerebral dysfunction.