2750 – Folie a Deux- Case Presentation and Discussion

Abstract

Introduction:

“Folie à deux” is also known in the ICD-10 as Induced Delusional Disorder. A subtype is “folie imposee” where the primary individual holds delusional beliefs shared by a secondary individual. When the delusional beliefs of the primary individual cease it is observed that the beliefs of the secondary individual also disappear. Mr A was a 36 year old Caucasian male presenting with an array of psychotic symptoms centred on a task which involved finding an energy source at the centre of the earth. Mrs A was highly resistant to his treatment and further investigation revealed a case of folie à deux.

Objectives:

To demonstrate the phenomenon of folie à deux.

Methods:

Individual and combined interviews were held with Mr and Mrs A where the psychotic symptoms were discussed. A comprehensive study of Mr A's past and current psychopathology was also undertaken.

Results:

Mrs A shared the delusions of her partner and was strongly against treatment as it would nullify his delusions rendering him incapable of completing his task. Once treatment was facilitated, Mr A experienced a drop from his unusually high levels of energy which reflected an equal and immediate drop in energy levels of his partner which led her to further discourage him from medication. When Mr A's delusional beliefs lifted, it was apparent that his partner no longer held the same delusional beliefs.

Conclusions:

We concluded this case fulfilled ICD-10 and DSM IV criteria for a shared delusional disorder (folie à deux) with specific sub-type “folie imposee”.