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Excerpt from Shared Psychotic Disorder


Synonyms, Key Words, and Related Terms: shared paranoid disorder, psychosis by association, imposed psychosis, infectious insanity, folie à deux, folie à quater, folie à famille, folie imposée, folie simultanée, folie communiquée, folie induite, mental illness, psychosis, delusional disorder, delusional illness, delusions, schizophrenia, mood disorders

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Shared psychotic disorder, or folie à deux, is a rare delusional disorder shared by 2 or, occasionally, more people with close emotional ties. An extensive review of the literature reveals cases of folie à trois, folie à quatre, folie à famille (all family members), and even a case involving a dog.

Table 1. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and International Statistical Classification of Diseases, 10th Revision (ICD-10R) Criteria

DSM-IV-TR Diagnostic Criteria for 297.3 Shared Psychotic DisorderICD-10 Diagnostic Criteria for F.24 Induced Delusional Disorder (Folie à Deux)
  1. A delusion develops in an individual in the context of a close relationship with another person or persons, who have an already established delusion.
  2. The delusion is similar in content to that of the person who already has an established delusion.
  3. The disturbance is not better accounted for by another psychotic disorder (eg, schizophrenia) or a mood disorder with psychotic features and is not due to the direct physiological effects of a substance (eg, drug abuse, medication) or a general medical condition.
  1. Two people share the same delusion or delusional system and support one another in this belief.
  2. They have an unusually close relationship.
  3. Temporal or contextual evidence exists that indicates the delusion was induced in the passive member by contact with the active partner.


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