Folie a trois in a multilevel security forensic treatment center: forensic and ethics-related implications

Shared (Induced) Delusional Disorder commonly occurs in close relationships and involves a varying number of participants who may be nonconsanguineous. The disorder has been associated with forensic and fatal consequences. Its occurrence in three nonrelated, incarcerated individuals is described in this article. This case of folie à trois has forensic implications and raises several questions of ethics that relate to autonomy, confidentiality, safety, and risk estimation. The presentation, management, and outcome of the patients suggest that a high index of suspicion is needed to detect cases in similar settings. The report concludes that the rarity of the disorder in a forensic mental health population may be the result of underdetection, given that conditions are conducive to the development of the disorder. Telltale signs of its manifestation are hypothesized as being responsible for some events in incarcerated populations. Physical separation and antipsychotic medications remain the mainstay of treatment.     

“Folie circulaire” vs “Folie à double forme”: Contribution from a French national study

Objective

To check whether the presence or not of free intervals between episodes could help differentiate subtypes of bipolar disorder, as suggested by the seminal controversy between Falret and Baillarger.

Methods

From 1090 bipolar I patients included in a French national study, 981 could be classified as with or without free intervals and assessed for demographic and illness characteristics.

Results

Compared with patients with free intervals (n = 722), those without (n = 259) had an earlier age at onset, more episodes, suicide attempts, cyclothymic and irritable temperaments. The following independent variables were associated with no free intervals: being single or divorced, delay to mood stabilizer treatment, multiple hospitalizations, incongruent psychotic features, panic and generalized anxiety disorder.

Conclusion

“Folie à double forme” (without free intervals) and “folie circulaire” (with free intervals) may actually refer to early and later onset bipolar subtypes, insofar as most differences we found between them were previously evidenced between the latter two. We cannot, however, exclude that they might simply be two separate subtypes, whose main characteristics could be accounted for by different explanatory factors.     

Folie à deux in a child

Folie à deux is the transference of delusional ideas and behaviors from one person to another with whom there has been a close association. Its occurrence in children has been rarely described in the literature, which was reviewed for case reports, diagnostic criteria, and etiological theories. A detailed case history of a 10- year- old girl who had delusions of special powers and delusions of persecution as well as hypochondriacal and hysterical symptoms is presented as an example of folie à deux between child and parent. This girl had developed a symbiotic incestuous relationship with her stepfather, a paranoid schizophrenic patient. Six criteria for making the diagnosis of folie à deux in a child were applied to the case studied. General and specific aspects of treating this disorder were discussed.     

Folie a deux-the psychosis of association

Psychiatric Quarterly -     

Folie a deux-the psychosis of association

Psychiatric Quarterly - This paper is intended as a complete review of the subject offolie à deux, or, as it may better be called, the psychosis of association. It contains: a short historical...     

Folie a deux in bipolar affective disorder: a case report

Background:  The syndrome of folie a deux is uncommon and often described in the context of schizophrenia. We report a case of induced delusional disorder associated with bipolar affective disorder (BAD).
Case report:  We present a case of monozygotic twins in their late 60s with an unusually close relation with one another and relative isolation from other people. Both twins have been diagnosed as suffering from BAD and relapsed into mania with psychotic symptoms. During their hospital stay they exhibited features consistent with folie a deux. Separation caused disappearance of the phenomenon whilst the affective disorder persisted.
Conclusion:  This case highlights the unusual and rare phenomenon of folie a deux occurring in the context of BAD. It also suggests current difficulty in defining folie a deux as an entity according to current diagnostic criteria.     

Folie à six: a case report on induced psychotic disorder

A case of folie à six is described in which the persecutory delusions of the central figure spread to her husband and their 2 sons, and even to her sister-in-law and a nephew. The main factor in the development of this shared paranoid disorder seems to have been the dominant personality of the inducer. In contrast to reports in the literature, there was no family history of such disorders and there were no adverse social or environmental circumstances.     

Folie à deux revisited

Folie à deux (shared paranoid disorder) is misleadingly defined in DSM-III. It is not an illness in itself, but a phenomenon associated with delusional psychiatric illnesses. There are two main types of folie à deux. An updated nomenclature is proposed.     

Folie à deux and dementia

Folie à deux has been infrequently reported in dementia patients. A case is described in which both partners with folie à deux suffered from an Alzheimer type dementia. The development and management of folie à deux in dementia is discussed.