-“Doctor…My husband and his mom—they’re both crazy.”
Erica X., a pleasant middle-aged medical technician that I was treating for resilient frontal headaches, made that lapidary statement about her family. She was under stressful conditions at home as her husband and his mother seemed to be in concert to criticize and sabotage all her household decisions, with the inevitable emotional frustration.
Besides the fact that many men, amongst who I include myself, are lifelong “Momma’s boys” that infuriate their life partners with their eclectic behavior, there is a psychiatric condition that affects individuals who are in close proximity. What appears as a wifely exaggeration may be the little cousin of a rare but real disorder.
The “folie à deux”—shared psychosis—is a presently recognized psychiatric syndrome that manifests in delusions and hallucinations that are transmitted from one individual to the other. The DSM-IV identifies it as “shared psychotic disorder” and the ICD-10 calls it “induced delusional disorder.”
It was first identified by Charles Lasègue and Jean-Pierre Falret, two 19th century French psychiatrists, who divided it in two clinical categories:
- Folie imposée: a dominant individual (the inducer or the principal) elaborates a delusional belief during a psychotic episode and then imposes it on another one ( the acceptor or the associate).
- Folie simultanée: two individuals that have independent psychotic states influence the content of their respective delusions and their co-morbidity can trigger symptoms in each other.
These individuals perpetrated some of the greatest crimes and swindles in modern history.The typical case might have been the criminal duo of “Bonnie and Clyde” (the inducer and the acceptor).When both patients suffering from a “folie imposée” are separated, usually the delusions in “the acceptor” resolve without recurring to any medication.
I asked Erica X. if treating her mother-in-law would free her husband’s mind.
-“Well…How about treating both? Can’t afford to take any chances—”
What do you think? Please tell us.
Don’t leave me alone.