Faith, Folie à Famille, and Mummification: A Brief Review of the Literature and a Rare Case Report

Abstract

Folie à deux is a rare clinical syndrome characterized by the transference of delusional ideas from one person to one or more other people in close association with the primary affected patient. Mummification indicates the preservation of the corpse of a person for a variable period of time. A brief review of the literature in this field is presented, and an exceptional case is described, characterized by the association of both these rare phenomena. The case is an example of folie à fammille which developed out of a condition of extreme religiousness and seclusion of an entire family. The shared psychosis led to the horrible death of some of the family members, while the last surviving member of the family lived for more than a year and a half with their mummified remains. The Judge commissioned a forensic psychiatry assessment to verify the survivor's ability to bear witness. The development of the psychiatric syndrome and its consequences are extensively discussed.

Folie à deux (transtorno delirante induzido)

“…Delírio persecutório é o tipo de delírio mais comumente encontrado nessa síndrome 3 , embora conteúdos religiosos possam estar presentes e dificultar a diferenciação de onde termina a fé e onde a psicose começa 2 . No entanto, o fenômeno descrito no caso gerou sofrimento, não foi compartilhado por outros, aconteceu fora de um contexto religioso, demonstrou-se fora de controle pelos envolvidos e não proporcionou crescimento pessoal.…”

“…Folie à deux, ou transtorno psicótico induzido, é uma síndrome rara 1 caracterizada por transferência de delírios de um sujeito considerado primariamente psicótico para um ou mais sujeitos considerados secundários em relação à origem do delírio 2 . Os sujeitos estão envolvidos em um contexto de relacionamento próximo, e classicamente em situações de confinamento 3 .…”

“…Na literatura científica, pode-se encontrar essa síndrome com várias denominações: insanidade compartilhada, insanidade contagiosa, loucura infecciosa, psicose de associação e dupla insanidade 6 . Além disso, quando a síndrome é compartilhada por mais de duas pessoas, recebe nomes diferentes: folie à trois 2,6 , à quatre, à famille or à plusieurs 2 . Grande parte dos sujeitos indutores primários são mulheres e o compartilhamento acontece mais entre parceiros ou entre mães e filhos.…”

A Contagious Disorder: Folie à Deux and Dementia

“…[65][66][67][68][69] It has been hypothesized that the genetic dispositions toward schizophrenia can also play an important role in the development of FaD, especially in the case of twins. [64][65][66][67][68][69][70][71] In addition, it has been reported that individuals who develop FaD have a high risk of schizophrenia in their families, with a very high prevalence of schizophrenia in firstdegree relatives (6.5%-26.2%), which is similar to the prevalence seen in first-degree relatives of schizophrenic patients (5.0%-16.9%). 21 Despite this evidence, the extent of genetic influence is difficult to determine.…”

“…One article describes the extraordinary case of 3 elderly, intensely religious sisters who developed a shared psychosis: folie à trois led to the horrible death of 2 of them, while the third sister lived for more than a year and a half with their mummified remains. 71 There are also cases of FaD associated with suicide pacts. 77,78 In these cases, the relations between the psychotic partners (domination-subordination) change over to relations of double suicide (instigator-participant).…”