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      Folie à deux ou le partage de symptômes comme modalité relationnelle: à propos d’un cas Translated title: Folie à deux, symptoms sharing us a relationship modality: a case report

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          Abstract

          Le trouble psychotique partagé ou Folie à deux (FD) est une entité rare et controversée qui pose des problèmes d’ordre phénoménologique, nosographique et psychopathologique. Elle interroge la nature du délire et sa survenue en dehors d’une structure psychotique ainsi que la question de la contagion du symptôme en psychiatrie. Nous proposons l’analyse sémiologique d’un cas intrafamilial de Folie à deux, cas dont la particularité clinique est le partage de symptômes délirants mais aussi d’éléments psychotiques non délirant (déficitaires). A travers quoi nous revenons sur les caractéristiques épidémiologiques et les facteurs communs avec les autres cas rapportés dans la littérature dans différentes cultures. Nous dressons ensuite l’historique de l’entité et son évolution au fil des classifications depuis sa première description par Legrand jusqu’au DSM 5. Et de là, nous soulignons le caractère insuffisant d’une approche purement descriptive et mettons l’accent sur le lien possible avec d’autres situations cliniques plus fréquentes avec comme point commun la transmission entre deux ou plusieurs personnes de symptômes psychiques. Puis, nous proposons une réflexion psychopathologique qui s’axe essentiellement sur le partage du symptôme et non sa nature tout en interrogeant la fonction du délire au sein d’un couple délirant.

          Translated abstract

          Shared Psychotic Disorder or Folie à deux is a rare and controversial entity that raises phenomenological, nosographic and psychopathological issues. It questions the nature of dilusion and its occurrence outside the psychotic structure and also the issue of symptoms contagion in psychiatry. We offer a semiological analysis of an intrafamilial case of Folie à deux, a case with the clinical specificity of sharing not only delusional symptoms but also non-delusional psychotic elements. We then dig back in the epidemiological characteristics and common factors to other reported cases in the literature of different cultures. Then we draw a history of the entity and its evolution over the classifications since its first description by Legrand to the DSM 5. From here, we emphasize the insufficiency of a purely descriptive approach and focus on the possible link with other more common clinical situations of mental symptoms transmission between two or more persons. Then, we propose a psychopathological reflection that essentially targets the sharing of the symptom rather than its nature while questioning the function of the delusion in a delusional couple.

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          Most cited references 15

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          Physical anhedonia in the acute phase of schizophrenia

          Background The aim of the current study is to investigate the relationship between physical anhedonia and psychopathological parameters, pharmacological parameters or motor side-effects in a sample of inpatients with schizophrenia in an acute episode of their illness. Method Eighty one patients with schizophrenia, consecutively admitted, with an acute episode of their illness, at the Eginition Hospital, Department of Psychiatry, University of Athens, during a one-year period were investigated regarding possible relationships between physical anhedonia, social-demographic data and clinical parameters as well as motor side-effects, induced by antipsychotic agents. All patients were assessed using the Chapman Revised Physical Anhedonia Scale (RPAS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side-Effects (EPSE), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS). Simple cross tabulations were initially employed. Subsequently, multiple regression analysis was performed. Results Both positive and negative symptoms were associated with physical anhedonia. A positive association between physical anhedonia and the non-paranoid sub-category of schizophrenia was also proved. Conclusion According to these results, it seems that in the acute phase of schizophrenia, physical anhedonia may be a contributing factor to patient's psychopathology.
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            Induced delusional disorder. a review of the concept and an unusual case of folie à famille.

            Induced delusional disorder (or shared paranoid disorder), also known as folie à deux, is a fairly uncommon disturbance characterized by the presence of similar psychotic symptoms in two or more individuals. Most often the symptoms are delusional. Usually the 'primary' case, i.e. the individual who first develops psychotic symptoms, can be distinguished from one or more 'secondary' cases, in whom the symptoms are induced. We discuss the concept of shared paranoid disorder and consider various aetiological, clinical and diagnostic issues related to the disturbance. We also describe a case of folie à famille, this condition being a type of shared paranoid disorder. The case involves a couple and their 12-year-old son. The boy's father is the 'primary' case, whilst the boy and his mother are both 'secondary' cases. The boy was admitted to our child and adolescent psychiatric unit for in-patient treatment. Treatment success was moderate in terms of improving the features of folie à famille in the three individuals involved. Copyright 2003 S. Karger AG, Basel
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              Folie à deux in Japan -- analysis of 97 cases in the Japanese literature.

               H Kashiwase,  M Kato (1997)
              In order to clarify the characteristics of folie à deux in Japan, we examined a total of 97 cases of folie à deux in the Japanese literature covering a period of 90 years, and compared them with the cases reported in Western countries. About 75% of the Japanese cases occur in two individuals, and of these are family cases. The most common combinations are mother-child and married couple. Mother-child combinations are much more common than father-child combinations. Female subjects are more often involved than males. The most common diagnosis for the dominant partner is schizophrenia, and the most common diagnosis for the submissive partner is paranoid reaction. Delusion is the most common symptom shared by both partners in Japan. Comparing these Japanese cases to Western ones, sister-sister combinations are less frequent, younger subjects influence the older ones more, and acute religious delusion is more common in Japan than in Western countries.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                28 January 2019
                2019
                : 32
                Affiliations
                [1 ]Service de Psychiatrie, Centre Hospitalier Universitaire Hassan II, Fès, Maroc
                Author notes
                [& ]Corresponding author: Amine Bout, Service de Psychiatrie, Centre Hospitalier Universitaire Hassan II, Fès, Maroc
                Article
                PAMJ-32-47
                10.11604/pamj.2019.32.47.8378
                6522158
                © Amine Bout et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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