1
|
Alarcón Ariza DF, Zambrano Jerez LC, Ramírez Rivero CE, Niño García JA, Ruiz Quecan AC, Domínguez Alvarado GA. Burns in the context of a shared psychotic disorder in a Colombian referral centre: A case report. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:156-160. [PMID: 37460342 DOI: 10.1016/j.rcpeng.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/05/2021] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder. CASE We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia. CONCLUSIONS The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
Collapse
Affiliation(s)
- Diego Fernando Alarcón Ariza
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia.
| | - Laura Cristina Zambrano Jerez
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Carlos Enrique Ramírez Rivero
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Jorge Andrés Niño García
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | - Adriana Catalina Ruiz Quecan
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | | |
Collapse
|
2
|
Alarcón Ariza DF, Zambrano Jerez LC, Ramírez Rivero CE, Niño García JA, Ruiz Quecan AC, Domínguez Alvarado GA. Burns in the Context of a Shared Psychotic Disorder in a Colombian Referral Centre: a Case Report. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00076-7. [PMID: 34083077 DOI: 10.1016/j.rcp.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/22/2020] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Shared paranoid disorder is characterised by the development of psychotic symptoms in people who have a close affective bond with a subject suffering from a mental disorder. This case is the first case of burn injuries reported in the context of this disorder. CASE We describe a young couple, with a similar pattern of burns caused by contact with a griddle. The injuries are the result of the aggression caused by a relative of one of them, who presented psychotic symptoms, related to the previously undiagnosed spectrum of schizophrenia. CONCLUSIONS The impact of this condition encompasses social, physical and psychological components, requiring multidisciplinary management and a high index of diagnostic suspicion.
Collapse
Affiliation(s)
- Diego Fernando Alarcón Ariza
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia.
| | - Laura Cristina Zambrano Jerez
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Carlos Enrique Ramírez Rivero
- Programa de Cirugía Plástica, Estética y Reconstructiva, Hospital Universitario de Santander, Universidad Industrial de Santander, Colombia
| | - Jorge Andrés Niño García
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | - Adriana Catalina Ruiz Quecan
- Departamento de Salud Mental, Hospital Universitario de Santander, Hospital Psiquiátrico San Camilo, Universidad Industrial de Santander, Colombia
| | | |
Collapse
|
3
|
Menculini G, Balducci PM, Moretti P, Tortorella A. 'Come share my world' of 'madness': a systematic review of clinical, diagnostic and therapeutic aspects of folie à deux. Int Rev Psychiatry 2020; 32:412-423. [PMID: 32363956 DOI: 10.1080/09540261.2020.1756754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Folie à deux, also known as shared psychotic disorder, shows intrinsic differences when compared to other psychiatric disorders. Literature about this condition is scanty and findings about its clinical correlates are not univocal. The present systematic review aimed at critically summarizing the existing evidence about folie à deux, also focussing on psychopathological, diagnostic and treatment features. The electronic databases PUBMED, Web of Science and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles reporting original data about socio-demographic, aetiological, clinical, diagnostic and treatment features of folie à deux, providing information about both primaries and secondaries, were included. Risk of bias was evaluated using the Critical Appraisal Skills Programme (CASP) instruments. The initial search yielded 834 records. After the screening process only 9 papers were deemed eligible for inclusion in the review. Folie à deux emerged to be a heterogeneous condition with a complex etiopathogenesis. The clinical presentation of the disorder included a multi-facet aspect, going beyond the classical description mainly focussed on delusions and possibly explaining conflicting outcomes of different treatments. Diagnostic categories appear to be often reductive and the need for a dimensional approach capable of global reliability emerged.
Collapse
|
4
|
Guivarch J, Piercecchi-Marti MD, Poinso F. Folie à deux and homicide: Literature review and study of a complex clinical case. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 61:30-39. [PMID: 30454559 DOI: 10.1016/j.ijlp.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/11/2018] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
UNLABELLED Folie à deux is a psychiatric illness involved in homicides. OBJECTIVE To study the mechanisms leading to homicide and determine homicide risk factors in folie à deux patients through a literature review and the study of a complex clinical case. MATERIALS AND METHODS We included articles available on PubMed, ScienceDirect or Cairn that address the forensic implications of folie à deux. Then, we analyzed the criminal psychiatric assessments of two murderers (husband and wife) of a child in a case of folie à deux. RESULTS Seventeen articles were included. In the cases examined, homicides were committed with great violence, usually against a victim in the family circle, and were sometimes followed by suicide. The main risk factor for homicide was the combination of mystical and persecutory delusions. The homicides occurred in response to destabilization of the delusional dyads. Concerning the clinical case, we described the circumstances surrounding the killing and analyzed the four expert reports that permit us to infer the occurrence of induced psychosis, which is a form of folie à deux. DISCUSSION Psychiatrists must attain a better knowledge of folie à deux to allow early identification of risk situations and to improve their assessments.
Collapse
Affiliation(s)
- J Guivarch
- Service de pédopsychiatrie, CHU Sainte Marguerite, 270 boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Faculté de medecine de Marseille, Aix-Marseille Université, France; Institut des Sciences Criminelles, Poitiers, France.
| | - M D Piercecchi-Marti
- Faculté de medecine de Marseille, Aix-Marseille Université, France; Service de Médecine Légale et Droit de la Santé, CHU Timone, 13385 Marseille Cedex 5, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - F Poinso
- Service de pédopsychiatrie, CHU Sainte Marguerite, 270 boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Faculté de medecine de Marseille, Aix-Marseille Université, France.
| |
Collapse
|
5
|
Cipriani G, Abdel-Gawad N, Danti S, Di Fiorino M. A Contagious Disorder: Folie à Deux and Dementia. Am J Alzheimers Dis Other Demen 2018; 33:415-422. [PMID: 29772920 PMCID: PMC10852512 DOI: 10.1177/1533317518772060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Folie à deux is a clinical condition that was first described in 19th century. It is a psychotic disorder in which two closely associated individuals share a similar delusional system. OBJECTIVES The aim of this article is to review the nosological significance of folie à deux and to explore the disorder among patients with dementia. METHODS Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published before 2017. Search terms used included dementia, folie à deux, induced delusional disorder, neurocognitive disorders, shared psychotic disorder. Publications found through this indexed search were reviewed for further relevant references. RESULTS AND CONCLUSION Cases of Folie à deux involving patients with dementia are reported quite infrequently. Most of the studies on the topic consist in case reports. Clinicians are obliged to treat the disorder. They should be alert to the potential high risk inherent this psychotic syndrome.
Collapse
Affiliation(s)
- Gabriele Cipriani
- Department of Neurology, Versilia Hospital, Lucca, Italy
- Department of Psychiatry, Versilia Hospital, Lucca, Italy
| | - Noha Abdel-Gawad
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sabrina Danti
- Department of Neurology, Versilia Hospital, Lucca, Italy
| | | |
Collapse
|
6
|
|
7
|
Feeney EJ, Groman SM, Taylor JR, Corlett PR. Explaining Delusions: Reducing Uncertainty Through Basic and Computational Neuroscience. Schizophr Bull 2017; 43:263-272. [PMID: 28177090 PMCID: PMC5605246 DOI: 10.1093/schbul/sbw194] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Delusions, the fixed false beliefs characteristic of psychotic illness, have long defied understanding despite their response to pharmacological treatments (e.g., D2 receptor antagonists). However, it can be challenging to discern what makes beliefs delusional compared with other unusual or erroneous beliefs. We suggest mapping the putative biology to clinical phenomenology with a cognitive psychology of belief, culminating in a teleological approach to beliefs and brain function supported by animal and computational models. We argue that organisms strive to minimize uncertainty about their future states by forming and maintaining a set of beliefs (about the organism and the world) that are robust, but flexible. If uncertainty is generated endogenously, beliefs begin to depart from consensual reality and can manifest into delusions. Central to this scheme is the notion that formal associative learning theory can provide an explanation for the development and persistence of delusions. Beliefs, in animals and humans, may be associations between representations (e.g., of cause and effect) that are formed by minimizing uncertainty via new learning and attentional allocation. Animal research has equipped us with a deep mechanistic basis of these processes, which is now being applied to delusions. This work offers the exciting possibility of completing revolutions of translation, from the bedside to the bench and back again. The more we learn about animal beliefs, the more we may be able to apply to human beliefs and their aberrations, enabling a deeper mechanistic understanding.
Collapse
Affiliation(s)
- Erin J Feeney
- Department of Psychiatry, Ribicoff Research Facilities, Connecticut Mental Health Center, Yale University, Park Street, New Haven, CT, USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
| | - Stephanie M Groman
- Department of Psychiatry, Ribicoff Research Facilities, Connecticut Mental Health Center, Yale University, Park Street, New Haven, CT, USA
| | - Jane R Taylor
- Department of Psychiatry, Ribicoff Research Facilities, Connecticut Mental Health Center, Yale University, Park Street, New Haven, CT, USA
| | - Philip R Corlett
- Department of Psychiatry, Ribicoff Research Facilities, Connecticut Mental Health Center, Yale University, Park Street, New Haven, CT, USA
| |
Collapse
|
8
|
Abstract
We reconsider delusions in terms of a "doxastic shear pin", a mechanism that errs so as to prevent the destruction of the machine (brain) and permit continued function (in an attenuated capacity). Delusions may disable flexible (but energetically expensive) inference. With each recall, delusions may be reinforced further and rendered resistant to contradiction. We aim to respond to deficit accounts of delusions - that delusions are only a problem without any benefit - by considering delusion formation and maintenance in terms of predictive coding. We posit that brains conform to a simple computational principle: to minimize prediction error (the mismatch between prior top-down expectation and current bottom-up input) across hierarchies of brain regions and psychological representation. Recent data suggest that delusions may form in the absence of constraining top-down expectations. Then, once formed, they become new priors that motivate other beliefs, perceptions, and actions by providing strong (sometimes overriding) top-down expectation. We argue that delusions form when the shear-pin breaks, permitting continued engagement with an overwhelming world, and ongoing function in the face of paralyzing difficulty. This crucial role should not be ignored when we treat delusions: we need to consider how a person will function in the world without them..
Collapse
Affiliation(s)
- S.K. Fineberg
- Yale University, Department of Psychiatry, Ribicoff Research Facility. 34 Park Street, New Haven, CT, USA 06519
| | - P.R. Corlett
- Yale University, Department of Psychiatry, Ribicoff Research Facility. 34 Park Street, New Haven, CT, USA 06519
| |
Collapse
|
9
|
Freeman LP, Cox RE, Barnier AJ. Transmitting delusional beliefs in a hypnotic model of folie à deux. Conscious Cogn 2013; 22:1285-97. [DOI: 10.1016/j.concog.2013.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 01/12/2023]
|