Shared Psychotic Disorder: A Psychosocial Psychosis?

Abstract

Shared Psychotic Disorder (SPD) is the development of a delusion in an individual in the context of a close relationship with another who has an existing delusion. SPD has consistently been interpreted from a psychiatric perspective with little regard for the relational component of the sharing of delusions between individuals. We review the epidemiology, etiology, and clinical symptomatology of SPD, together with various theoretical perspectives on the disorder. Treatment options are presented beyond the usual physical separation of the delusional individuals.

Uncommon psychopathological syndromes in psychiatry

“…The authors supported their observation with evidence from a study in which they analyzed seven cases of induced delusional disorder, in all of which the induced had a mental, physical or other type of disability [150]. The secondary is very often a socially isolated person [152,155,157,158,173], who, characteristically does not maintain contact with others and is non-assertive and submissive. The isolation may even involve a total lack of external influence.…”

“…Symptoms of the primary disorder occur only in one of these persons (the inducer, the primary), and the other person/people (the induced/the secondary) show(s) induced delusions, which disappear when the patients are separated [154]. The induced is a heretofore healthy individual who acquires analogous delusions, which, however, are less strongly manifested than in the patient with the primary delusional disorder [155]. The literature provides data regarding the duration of the association between the inducer and induced and the length of exposure to the inducer's psychosis [156].…”

“…Separation of the patients may be ineffective. • folie communiquée (communicated insanity) -after a long period of resistance to psychosis, the individual who stays in contact with the primary patient develops his/her own independent delusions [155]. Because the delusions persist after separation of the patients, the two disorders should be diagnosed and treated individually.…”

“…Delusions in the course of folie à deux are most often systematic in nature [175]. Many authors emphasize the fact that the delusions are usually induced in a secondary when they have an element of reality [155]. The primary has intellectual and emotional dominance over the secondary.…”

“…The isolation may even involve a total lack of external influence. Such a situation may take place among emigrants who are often subject to cultural and linguistic isolation [155]. Delusions in recipients are less intense than in inducers [155], and their content seems to be more probable [165].…”