Psychiatry and Clinical Psychopharmacology

Treatment-resistant shared psychotic disorder (Folie a Deux)- mother and son: case report

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S251-S252
Read: 953 Published: 17 February 2021

Shared psychotic disorder (folie à deux) is characterized by the development of delusions in another person in the framework of close relationship with the case that has psychotic disorder where clear delusions are dominant. This study will discuss primary a case diagnosed as having schizophrenia and his mother, who shares his delusions. Primary CASE: Our case is a single male patient, aged 44, a teacher and unmarried and unable to work for 7 years. While the patient was living with his mother and father, his father passed away 8 years ago. He was thinking that his phone was wiretapped and followed. He shared these with his mother. After a while, his mother started to share the same thoughts with him. The patient started not going to job. They started to live on streets and they were constantly wandering about. They wandered about in streets for 8 years and slept at mosques’ gardens or in passage at night. During the psychiatric examination, the patient looked a bit older than his age, his self-care was decreased and was eager to speak and tell the incidents. Associations accelerated. He said that chip was inserted in him and he was thus being followed. Hallucination was not detected. He had no insight. Reasoning was partially sufficient. Cognitive functions were natural. Risperidone 4mg/day and biperidene 5mg/day treatment was launched. It was increased over time and adjusted as 8mg/day. Olanzapine 10 mg/day was added to the treatment of the patient who complained of sleep deprivation and 8 sessions ECT were performed but no change occurred in the patient’s delusion. Clozapine treatment was launched and was increased to 400 mg/day. Since no regression occurred in the complaints, amisulpride treatment was added and increased to 800 mg/day. After the fact that the desired improvement was not seen, valproic acid 1000mg/day was added to the treatment. Partial improvement was observed in patient’s delusions at the end of two months after his hospitalization. Secondary case: Our case is a female, aged 70, primary school graduate and has 2 children. She is the mother of the primary case. She has never had any psychiatric complaints. She says that his son has been installed a chip and thus, the organization has been following them. Affection is limited, self-care is medium and she shows her age. She is willing to interview. She has no hallucination. She has paranoid persecutory delusion in thought. Her cognitive functions are sufficient. Reasoning is impaired and she has no insight. 10 mg olanzapine treatment was launched for the patient. After sufficient response was not taken, the dose was increased to 20 mg/day. Partial recovery was observed after approximately one month. In 97% of the cases, the disorder develops between two members of nuclear family. It is frequent in family types, where autonomy of family members is restricted and their personal borders are not definite. Similarly, our primary case is unmarried and lives with his parents. Delusion inheritance of the secondary case did not disappear immediately and partial recovery could be achieved with the treatment in both cases.

EISSN 2475-0581