SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Induced psychotic disorder in infrequent. We report a case in which four members of the same family were affected. The bibliography is reviewed and certain etiological factors implicated in our case are discussed.
A 50-year-old married woman with a history of recurrent depression developed a severe abnormal grief reaction following the death of her son (who had recovered from an eating disorder) in a car crash. The patient reported a number of bizarre rituals involving her son's ashes and personal effects obtained post mortem. She developed anorexia nervosa four months after his death.
Induced psychotic disorder is infrequent. We report a case in which three members of the same family were affected. We analyzed certain etiological factors, family relationship and social and environmental conditions.
The disorder folie à deux is described from the literature with the classical subdivision into four groups, and the characteristic features and involved mechanisms essential to the disorder are presented. Three cases are described, two of them concerning twins, namely a sister-sister and a brother-brother relationship, together with a mother-daughter relationship. The cases show the characteristics in folie à deux: 1. An intimate relationship; 2. Social isolation; 3. Delusions similar in content. Ways of treatment are described.
This paper describes four cases of Munchausen Syndrome by Proxy (MSbP), in each of whom the disorder could be considered mild from the physical viewpoint. However, in all cases a severe emotional disturbance was evident in the mother-child relationship, and certain significant features were common to each case, including the dynamics of the development of the disorder. In all, maternal anxiety resulted in the mother perceiving the child as sick, leading to her insistence that he/she receive medical attention. A follow-up over several years showed severe disturbances in the emotional development of all the children. It is thus suggested that mild cases of MSbP may be indicators of severely disturbed mother-child relationships, raising important questions about their proper management.
Folie a deux is thought to occur in persons who live close together, so that delusions of the primarily ill patient are adopted by the partner. Alternatively, if both patients are related, they may share the same genetically driven psychiatric illness. We present the cases of two psychotic couples (monozygotic twins and a mother and daughter pair, respectively), in which both subjects featured an almost identical psychopathological syndrome with the same delusional content and thus fulfilled the diagnostic criteria of folie a deux. When Leonhard's diagnostic system was applied, all four patients were found to suffer from affect-laden paraphrenia, arguing against the presence of folie a deux in those dyads. Thus, thorough psychopathological examination in suspected folie a deux settings can help to obtain valid diagnoses.
A case of folie à deux dissociative (dissociative hysteria) disorder in an 8 and 12 year-old sister and brother is presented. Illnesses of this type are very rare and there is little medical literature on this subject. Our patients, almost simultaneously, abruptly had complete loss of memory, disorientation, loss of awareness about who they were, and much anxiety, which lasted about 15 hours. Both patients were physically well and no abnormalities were found on physical examination, routines laboratory tests and EEG studies. Speculations about the emotional and interpersonal causes of this illness in these two patients are given.
Following an earlier description of the psychopathological conceptions of "communicated insanity" we focus on a remarkable difference concerning the development of the historical terminology. The current operationalized definition is oriented at the originally French conception of the "folie à deux" which includes an adoption of certain delusional ideas by an intimate other. Compared with that, in the German psychopathological tradition those cases were also included in the conception of the "induziertes Irresein", in which the shocking experience of another's psychosis may cause a psychotic illness of somebody else. In modern psychiatric terminology this kind of "induction" is rather disregarded. We report a case of an induced psychosis in two women and give particular attention to the German psychopathological tradition because of still existing clinical relevance.
OBJECTIVE: To search the literature to reassess the concept of shared psychotic disorder (SPD) using modern nosology and current biopsychosocial formulation. METHOD: Analyzing published case reports from 1942 through to 1993 that meet DSM-IV criteria for SPD according to patient age, sex, nature and duration of the relationship with the "primary", length of exposure to primary's psychosis, family psychiatric history, comorbidity, social isolation of the dyad, presence of hallucinations, delusional type, and the diagnosis of the primary. RESULTS: Findings revealed: 1. males and females were affected with equal frequency; 2. there was equal prevalence in younger and older patients; 3. the majority of shared psychoses (90.2%) were equally distributed among married couples, siblings, and parent-child dyads; 4. comorbid dementia, depression, and mental retardation were common; 5. hallucinations were common; 6. the majority of dyads (67.3%) were socially isolated. CONCLUSIONS: SPD probably occurs in premorbidly disposed individuals in the context of social isolation which is shared with a psychotic person.
PURPOSE: This report describes the uncommon psychopathological state best known as folie à deux, or shared psychotic disorder, in a unique case in which the grandiose, religious delusions of a woman with uterine cancer are shared with her husband. OVERVIEW: More than 50% of patients with cancer meet the criteria for diagnosis of major psychiatric disorders. Certainly, these disorders may occur as a result of the stress of the cancer diagnosis and treatment, but also because of a predisposition to psychiatric illness or a pre-existing psychiatric illness. In the medical setting, the phenomenon of folie à deux poses significant problems not only for the patient, but also for the involved family member, psychiatric consultant, and healthcare team. CLINICAL IMPLICATIONS: In this case, the patient's delusional system had a grave impact on her ability to make rational healthcare decisions, for which she was deemed incompetent. The first choice for her healthcare surrogate, her husband, was so affected by his sharing of her psychotic condition that he could not fulfill this role. In assessing a suspected case of folie à deux, awareness of several issues--the point at which religious over-ideation becomes delusional, the spectrum of competency, informed consent, and treatment refusal--is important.
OBJECTIVE: This paper is written with the aim of presenting a series of cases of folie à deux, an unusual disorder, occurring in a forensic setting where all the victims suffered a fatal or near-fatal outcome. Similarities in the psychopathology in these cases are drawn and comments are made about their outcome in court. The paper is also written to draw attention to the potential risks involved in this type of case and to accent patterns in psychopathology and in legal outcomes. CLINICAL PICTURE: Five folie à deux cases are described. All are well known to one of the authors (NK), who has treated them at some stage of their illness, provided medicolegal reports for the trial of cases 3, 4 and 5, and provided expert witness testimony in the trial of case 3. All case notes and other relevant documents were studied in detail and a brief summary is provided for each case. OUTCOME: The cases appear to conform with the description of folie à deux given in the literature and consist of husband and wife (three cases), mother and daughter (one case) and twin brothers (one case). None of these cases had had any past psychiatric or criminal history, yet all the victims suffered a fatal or near fatal outcome. Additionally, all had shared religious delusions in one form or another. CONCLUSIONS: Folie à deux cases with shared religious delusions can be a very high risk and could be potentially fatal in a family setting. The authors also highlight the difficulties inherent in a forensic system restricted to McNaughton rules, particularly when a person is on trial having committed, or being alleged to have committed, a serious offence, and who is found to be suffering from a psychotic illness.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The ego development of 22 postoperative female-to-male transsexuals and their spouses or lovers with whom they had been living for a year or more was investigated. The transsexuals, their spouses, and a control group of 22 couples were administered the Washington University Sentence Completion Test of Ego Development, a projective measure of ego functioning. Ego development refers to the framework of meaning that the individual brings to an experience. The construct of ego development incorporates a series of sequential stages that integrate various frames of reference including cognitive style, interpersonal style, conscious preoccupation, and impulse control. These processes have received little attention in studies on female-to-male transsexuals who have successfully negotiated the social barrier of cross-living to the extent that they are living the male role in a heterosexual relationship. No significant differences in the distribution of ego development scores were found between the transsexuals and the control males, or between the transsexuals' spouses and the control spouses. Over 93% of the transsexuals and their spouses scored above the conformist level of ego development. These findings are discussed in terms of some of the previous literature on conformist thinking by transsexuals.
Thirty-five partners were identified in a group of 72 transsexuals. Six male-to-female transsexuals continued to live with their marriage partner, but the remainder of the total group cohabited with a member of the same biological sex. Two of the female-to-male transsexuals had undergone a marriage ceremony with their present partner, but the remainder had not. In most cases the social class of the partner was the same as that of the transsexual. In one case two transsexuals were living together, and this case and three others out of a total of six who were interviewed are described in more detail. The partnerships described support the view that transsexualism is best regarded as an overvalued idea which may be accepted or shared by a partner. The extent to which the idea is shared is related to the bond of affection between the partners, the pattern of dominance between them, and the sexual needs of the partner.
Explore the source record for details and available documents.
The phenomenon of shared delusions was found in 9 (8.4%) of 107 personally investigated patients suffering from delusions of infestation (88 females, 19 males). A greater number of females (ratio of females to males 3.5:1) "induced" others, whereas a gender ratio of 1:1 was evident in the group of affected patients. Since the ratio of blood relations to non-blood relations was 1:2.3, genetic factors seem to play a less important role than the direct impact of deluded patients on their environment. The rare occurrence of shared delusions of infestation leads to the conclusion that only persons with a paranoid predisposition (paranoide Bereitschaft) may be affected. Cases of induced delusions are also described in which attending physicians act as "inducers".
Explore the source record for details and available documents.