Shared Psychotic Disorder (Folie à Deux)
A rare condition in which delusional beliefs are transferred from one individual with a primary psychotic disorder to another closely associated person.
Overview
Shared psychotic disorder, also known as folie à deux, involves the transfer of delusional beliefs from an individual with an established psychotic disorder to another person who is closely associated with them, typically in a relationship marked by social isolation.
Signs and Symptoms
Symptoms in the affected secondary individual can include adopting the same delusional beliefs as the primary individual, without other prominent psychotic symptoms of their own. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.
Causes and Risk Factors
Close, often socially isolated relationships with a person experiencing an untreated psychotic disorder are central to how shared delusions develop.
Diagnosis
A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.
Treatment
Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.
Psychotherapy
Separation from the individual with the primary disorder, combined with psychiatric evaluation, is often a key part of treatment.
Medication
Treatment of the primary individual’s underlying psychotic disorder is central; antipsychotic medication may be considered for the secondary individual if delusions persist after separation. Medication decisions should be made with a qualified prescribing healthcare professional. Do not start, stop, or change a prescribed medication based solely on information on this page.
Living With Shared Psychotic Disorder (Folie à Deux)
Support in rebuilding independent social connections outside the affected relationship can aid recovery.
When to Seek Professional Help
Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.
Emergency Situations
If a person may be in immediate danger, is experiencing a medical or psychiatric emergency, or may harm themselves or another person, seek immediate assistance through appropriate local emergency services.
Outlook
Many secondary individuals show improvement once separated from the person with the primary disorder and connected with appropriate treatment.
Related Conditions
Medical Information Disclaimer
Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
- National Institute of Mental Health.
- World Health Organization. International Classification of Diseases, 11th Revision.