[Shared psychotic disorder] "Folie a deux"

ABSTRACT

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