23 May What Causes Shared Psychotic Disorder And How To Treat?
Shared Psychotic Disorder (SPD), also known as Folie à Deux, is a very rare mental condition where one person shares false beliefs or symptoms of mental illness with another person.
This usually happens in close relationships, where one person has the false belief and the other person starts to believe it too.
This shows how strong human connections can affect mental health.
Although SPD is uncommon, it raises interesting questions about how psychology, surroundings, and relationships work together.
Most cases happen in close living situations without outside help, so the disorder often goes undiagnosed, as those affected just support each other’s false beliefs.
It’s important to understand the causes, symptoms, and treatment for proper diagnosis and care.
In this blog, we will look at what causes shared psychotic disorder, its signs, how it can be treated, and real-life examples to understand this interesting disorder better.
What Is Shared Psychotic Disorder?
Shared Psychotic Disorder (SPD), historically known as folie à deux (madness of two), is a rare psychiatric disorder where a delusion develops in an individual in the context of a close relationship with another person who already has a well-established delusional disorder.
From a psychiatrist’s viewpoint, Shared Psychotic Disorder (SPD) is:
- Rare Condition: A very uncommon psychiatric phenomenon.
- Delusion Sharing: A delusion is adopted by one person (secondary) from another (primary).
- Primary/Inducer: The primary individual has an existing, established psychotic disorder with delusions.
- Secondary/Induced: The secondary individual develops the same delusion as a result of the relationship.
- Close Relationship: Occurs in a very close, often isolated, emotional bond (e.g., family).
- Shared Content: The delusions are similar, if not identical, between the two.
- No Insight: Neither person typically recognizes their belief as a delusion.
- DSM-5 Reclassification: No longer a standalone diagnosis in DSM-5; falls under “Other Specified Schizophrenia Spectrum and Other Psychotic Disorders.”
- Vulnerability Factors: Social isolation, dependency, or stress can make the secondary person more susceptible.
- Treatment Core: Separation of individuals often leads to resolution in the secondary person. Psychotherapy and sometimes medication are also used.
How Rare is Shared Psychotic Disorder?
Shared Psychotic Disorder (SPD), is very rare, and there isn’t much data about how often it happens.
It is estimated to make up less than 1% of mental health cases.
Usually, it happens in close relationships, like between married couples, siblings, or parents and children, where being alone together and relying on each other can increase their willingness to believe each other.
Very Rare Condition – SPD is one of the rarest psychiatric disorders, with fewer than ten verified occurrences reported globally.
Difficult to Diagnose – SPD affects people who are emotionally related; hence, sharing delirious thoughts makes detection impossible.
Underreported and Misdiagnosed – The underreporting and misdiagnosis of this disorder related to other psychiatric conditions make its prevalence unknown.
Comorbidity with Pre-Existing Psychiatric Illness – Most of the time, the main person has a mental illness, like schizophrenia or paranoid thoughts, which then affects the other person.
Prevalence of Shared Psychosis Cases In India
There is not much information about how common Shared Psychotic Disorder (SPD) is in India because it is rare and often not diagnosed.
But a study from 1981 found that about 0.15 out of every 1,000 patients per year at a mental health clinic in Northern India had it, showing how rare it is.
In cities, the rate of general psychotic disorders, like schizophrenia, is about 0.64%, and it is lower in rural areas.
SPD likely makes up a small part of these cases.
It is hard to get accurate numbers because it is often not reported and diagnosing it can be difficult.
Types Of Shared Psychotic Disorder
Shared Psychotic Disorder (SPD) is described by the relationship between the people involved and the situation in which they share the false belief.
The DSM-5 does not specifically list different types of SPD, but medical writings mention different forms based on real-life examples and how the people relate to each other.
Here are the usual types or patterns of SPD:
1: Folie À Deux
The most common type of SPD, wherein two persons share a common delusional belief.
Typically occurs between family members, spouses, or close friends.
Usually, the dominant person in the relationship has a psychotic disorder and the submissive adopts their delusions.
2: Folie à Trois
Another type of less common SPD where three individuals share the same delusional belief.
It can develop in small isolated groups like some tightly knit families or friends living under the same roof.
3: Folie À Famille
Multiple members of a family simultaneously experience the same psychotic symptoms.
It occurs usually in families that interact very little with the outside world and upon which are heavily emotionally dependent.
It could lead an entire family to engage in conspiracy theorizing about supernatural happenings or persecution.
4: Folie À Plusieurs
A delusional belief is shared by a more comprehensive group, commonly seen in cults or isolated religious communities.
Typically, the leader or dominant figure will instill the delusion in others so they too accept the same false beliefs.
This phenomenon could lead to mass hysteria when the group acts upon the delusions in unison.
The types are not officially set but are based on what doctors have seen.
SPD is uncommon, and to diagnose it, doctors need to check for other mental disorders in the person affected.
Cultural and social factors, like family traditions in India, may affect cases like folie à famille.
Shared Psychotic Disorder Causes and Risk Factors
1) Causes of Shared Psychotic Disorder
Here are the key contributing factors and characteristics commonly observed as why psychosis occurs:
Close Emotional Bonds
These relationships tend to be very strong. Hence, the weaker member tends to develop shared delusions.
It is this emotional dependence that bias the weaker person to endorse irrational beliefs.
Social Isolation
Limited contact with outsiders prevents exposure to situations where alternative explanations might be entertained.
This provides constraint to the joint delusion by disallowing any external challenge.
Mental Illness on the Part of the Inducer
The cause of the delusion usually involves a person having a primary psychiatric condition such as schizophrenia, paranoid disorder, or other psychotic illnesses.
Most of the time, the person affected secondarily is usually the one who has less resistance or vulnerabilities to absorb these beliefs.
2) Risk Factors of Shared Psychotic Disorder
Shared Psychotic Disorder is influenced by specific risk factors that facilitate the transmission of delusional beliefs from a primary individual to a secondary one.
These include:
Genetics
Psychiatric family histories increase the incidence of SPD.
Individuals with family members diagnosed with schizophrenia or bipolar disorder appear at risk.
Stress and Trauma
Extreme psychological stress or the experience of traumatic events might trigger delusional sharing.
Anxiety, depression, or a history of abuse may predispose such individuals.
Dependence on the Primary Inducer
Generally, a secondary individual will have emotional or financial dependence on the dominant one.
This dependency further reinforces their belief; it makes it less likely that he/she would actively question or resist him/her.
Absence of Ability to Think Critically
Individuals incapable of independent reasoning or logical analysis are more likely to adopt such irrational notions.
Their susceptibility could be the result of insufficient learning as well as lack of exposure to a myriad of views.
Note: For accurate diagnosis and management of SPD, consult a psychiatrist like Dr. Vivek Pratap Singh (top psychiatrist in patna).
Shared Psychotic Disorder Signs And Symptoms
Shared Psychotic Disorder (SPD) is when one person with a mental illness shares their false beliefs with another person, who then believes them too.
The shared psychotic disorder symptoms vary based on the shared false belief and the people involved.
Here are the main signs to look for:
1: Delusional Ideas
Both subjects have illogical or contradictory beliefs.
Usually associated with conspiracy theories, being unlawfully hunted, or experiencing supernatural encounters.
2: Paranoia
Victim figures come to believe they are being observed, persecuted, or singled out for attention.
A heightened sense of awareness of an external threat can fuel excessive anxiety and defensive behaviors.
3: Hallucination
Occasionally shared perceptions may exist.
The individuals could hear voices or see something that is not there but which supports the existence of their delusions.
4: Social Withdrawal
Avoidance of the outside world, where people might confront their delusion.
One or both individuals often become socially reclusive and shun friends and family or any authority perceived as attempting to invalidate their false beliefs.
5: Unusual Behaviours
Acting according to a false belief, such as hiding from imaginary enemies.
Engaging in ceremonial or defensive measures to “protect” themselves.
6: Resistance to Logic
Being unreasonable often goes hand in hand with rejecting contrary evidence.
Ironclad emotional bonds to irrational beliefs allow for resistance to medical or psychological intervention.
Shared Psychotic Disorder Examples
Below are some real-life examples and shared psychotic disorder cases that illustrate SPD, drawn from documented instances:
Case of the Eriksson Twins (2008):
According to the delusional behavior of 2 Swedish twins named Ursula and Sabina Eriksson.
The two really believed they were in real danger and needed to escape.
This delusion drove them into traffic on the highway of Britain and caused serious injury.
It attracted a lot of attention for its synchronized, dangerous, reckless acts and, indeed, did highlight the intensity of shared delusions.
The Case of the Tromp Family (2016)
The whole family in Australia suddenly vacated their house and went off to a deafening, chaotic road trip.
They thought they were being chased, unbelievable as it was. Paranoia caused them to throw away mobiles and finally break apart during their travel.
They were found in confused and delusional states, a brilliant illustration of how shared psychosis spreads across communities of kin.
The Beck Case
A mother and her daughter lived for a significant amount of time alone, cultivating the delusion that there was a supernatural presence in their house.
Their shared paranoia grew so strong that they would not go outside of their house.
They reinforced each other’s fears, making it impossible for others to convince them.
Since SPD can coexist with other disorders like schizophrenia or mass psychogenic sickness, it is uncommon and frequently discussed in psychiatric literature.
In these cases, formal diagnoses were not always verified.
Shared Psychotic Disorder Reddit
As we have already mentioned in the begining, shared psychotic disorder is a rare psychiatric condition where two or more individuals share delusional beliefs, typically within close relationships.
On Reddit, discussions about this disorder often appear in mental health subreddits, where users share personal experiences, case studies, or seek advice about symptoms.
Posts may describe real-life examples, such as family members reinforcing each other’s delusions, or explore media portrayals like cult dynamics.
While Reddit offers community support and insights, users are encouraged to seek professional help, as the platform lacks verified medical expertise.
Shared Psychotic Disorder Diagnosis
It is hard to diagnose Shared Psychotic Disorder (SPD) because it is rare and looks like other mental illnesses.
Experts do thorough checks to tell it apart from confusion, schizophrenia, or drug-related psychoses.
Clinical Interviews
Psychiatry is connected to organized research talks about the types and progress of delusions.
These questions include when the delusions began, how they grew, and if more than one person is involved.
Medical and psychiatric history
The thorough history of those affected is taken to see whether or not primary psychological disorders accompany the condition.
It is important to consider the emotional and social attachment between involved individuals.
Psychological evaluation
Standardized psychological tests would look into cognitive functioning, logical reasoning, and proneness toward delusions.
These assessments serve as a tool to differentiate SPD from schizophrenia and other psychotic disorders.
Exclusion of Differential Diagnosis
Neurology, blood work, and brain images might all be performed, so as to rule out those differential diagnoses, including dementia, brain tumors, and even epilepsy.
Drug dependency is equally a screening due to a similarity in presentation characteristics with substance-induced psychosis.
Observation and Behavioral Analysis
Use case: This observation by mental health professionals holds true in studying how the affected individuals interact with one another and reinforce each other’s delusions.
Probably an indicator: whether the secondary individual’s symptoms improve after leaving the primary individual.
Shared Psychotic Disorder Treatment
Treatment for Shared Psychotic Disorder (SPD) aims to help the people involved by treating their symptoms, separating them, and stopping the spread of false beliefs.
Since SPD is uncommon, treatment methods are usually taken from general mental health practices for similar disorders.
Here is a simple summary of treatment methods based on known mental health guidelines:
Separation from the Primary Figure
Most of the time, the secondary individual tends to rapidly recover once removed from the influence of the delusion.
Disruption of the shared psychotic beliefs is the most effective method of treating these patients.
Antipsychotic Agents
Management of delusions and paranoia are done with several antipsychotics, such as Risperidone, Olanzapine, and Quetiapine.
Both persons may have to be started on treatment depending on symptom severity.
Cognitive Therapy
CBT focuses on people to recognize and challenge their irrational beliefs and replace them with more rational ones.
Cognitive restructuring, reality testing-even delusion-breaking techniques.
Family Therapy
Therapy helps family members understand SPD better and build healthier relationships.
This can lower the risk of relapse and encourage independent thinking in those affected.
Social Reintegration
Encouragement of being socially active, pursuing hobbies, and having organized activities helps avoid overwhelming loneliness.
Employment assistance and support groups help in resuming a sense of normalcy.
Hospitalization (In Severe Cases)
In serious situations, a person might need hospital care if they hurt themselves or could hurt others.
These cases are handled in a safe place where doctors provide first aid and create a treatment plan.
In short, Shared Psychotic Disorder treatment involves separating the individuals and providing individual therapy, often including antipsychotic medication for the primary patient.
It’s crucial to seek professional help promptly.
For specialized care in Patna, consider visiting Dr. Vivek Pratap Singh best psychiatrist in Kankarbagh Patna.
Conclusion
Shared Psychotic Disorder is a rare but serious mental health issue that affects close relationships.
The signs can be noticed early, which can help prevent long-term problems if professional help is sought.
Treatment options like separation, therapy, and medication can help the patient return to a healthy state of mind.
If this sounds like something you or someone you know is experiencing, the next step is to talk to a mental health professional for a proper diagnosis and advice.
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