[Psycological aspects of the alopecia]

Hair plays a primordial role both in relational life for the subject himself: natural ornament, privileged belonging of narcissism, and also a symbol of power and virility in man, of seduction and femininity in woman. The loss of hair "alopecia" is a real catastrophe: deep narcissism injury, feeling of uncovering. The first patient, aged 22, has shown an alopecia owing to stress which came with the father's disease. Dermatologic results were negative, psychiatric exam showed. The second patient, aged 14, was sent to us to dermatology service for alopecia of brutal appearance with no triggering factor, etiological results were negative. Psychiatric interview pointed out traits of a hysterical personality. Though alopecia aetiology is of various factors, psychological ones would be determining. In the first case the stress was acute, when as it was chronic in the second. Secondary benefit might could to maintain the disorder, than is a situation in the second case. The first case illustrates a decomposition of psychosomatique personality

[Shared psychotic disorder] "Folie a deux"

The so called " folie a deux" recently known according to DSM IV as shared psychotic disorder, is a rare and peculiar pathology of psychosis. Shared psychotic disorder is characterized by placing of delirium system in the subject, consecutive to a tight relationship with an inductor. We report a case of "folie a deux ". The primary delirious patient was a son who induced his delirium to his mother. The mother and son maintained a fusing relationship, clinically both of them said the same delirious talks about persecutions and bewitchment. The son's case was diagnosed as a brief psychotic disorder. Therapeutic attitude consisted of hospitalizing both patients in two separated departments. The mother underwent an anxiolytic treatment with a rapid symptomatic resolution. The son benefited from a neuroleptic treatment. Our clinical case illustrates the diagnosis of shared psychotic disorder depending on the diagnostic criteria of DSM IV. Many interesting points were raised, among them is the importance of the son's mother interaction, the determining cultural factors in elaboration of delirious content and delirium function in the mother. On the therapeutic level we proceeded to separate the two patients. Our clinical illustration aroused also reflection on the relation between the therapist and the delirious psychotic patient