The son was kept under observation with no drugs for nearly a week to further substantiate whether it was a case of imposed ( folie imposГ©) or simultaneous ( folie simultanГ©e) psychosis. After two weeks of treatment, she showed improvement and at the end of one month, reached partial clinical remission. The mother was started on antipsychotic treatment, which was titrated to a maximum of 30 mg of trifluperazine and 200 mg of chlorpromazine per day. Both were admitted in two separate closed wards and isolated from each other. There was no past history of mental illness or substance use in both the mother and the son. Physical examination and preliminary investigations were within normal limits.

A mental status examination revealed an equally unkempt and restless person with persecutory delusions but no perceptual abnormalities. It was at this stage that they were brought for admission. Following this, both the mother and the son had an aggravation of the illness with restlessness, decreased sleep and incessant speech using foul language directed at their neighbours. Two months back, he was bitten by a stray dog for which he vehemently refused treatment and hence the neighbours took him by force for antirabies injection. He too was found to be withdrawn, aloof and apprehensive about imminent danger. He started having behavioural changes 4 years back with similar beliefs of being harmed by his neighbours through witchcraft and black magic. The second patient was the only child of the primary case, a 20-year-old unmarried man staying with his mother. She was admitted to the hospital and after a detailed evaluation was diagnosed to have paranoid schizophrenia. She also had persecutory delusions, an anxious mood and third person auditory hallucinations. The rapport was poor, and her responses were brief and evasive. A mental state examination on the day of admission revealed an unkempt and agitated lady clinging to her son. She soon included her own family members in this conspirational network when she saw them with the neighbours on a number of occasions. She even forced her son to stay indoors and cut off all links with their neighbours. She stopped visiting them and actively resisted any social calls by them. She was often found verbally abusing the neighbours at the top of her voice. She also charged them with having used witchcraft and black magic to kill them. She accused her neighbours of plotting to do away with her and her son by poisoning their source of drinking water. The mother, a 40-year-old divorcee from a low socioeconomic background, with primary school education presented with continuous illness of 8 years' duration interspersed with exacerbations and partial remissions. We discuss the case of 2 patients with folie imposГ©, who presented to our OPD.

It is perhaps the most impressive example of a pathological relationship and, therefore, an understanding of its underlying mechanism has theoretical implications for other kinds of disturbed interpersonal relationships. 3 вЂ“ 7 It is certainly more common in isolated communities and families where there is a great urge to defend the status quo.ДЇolie Г deux is undoubtedly an intriguing condition of great relevance to the understanding of human psychopathology. Cases have been reported from beyond western societies, including Nigeria and India. 2ДЄn exact figure for the incidence and prevalence of folie Г deux is not available. folie a trois, folie a quatre, folie a cinq, or even a whole family, folie a famille. Although this condition involves two people, it can extend from the original subject to three, four, five persons, viz. вЂcommunicated insanityвЂ™, вЂcontagious insanityвЂ™, вЂinfectious insanityвЂ™, вЂpsychosis of associationвЂ™ and вЂdouble insanityвЂ™. 1 Many synonyms have been used for describing this condition, which mainly reflect the idea of the condition's transmissibility, viz. It was described as folie communiquГ© in 1860 by Baillarger and as folie Г deux in 1877 by Lasegue and Farlet. The term folie Г deux includes several syndromes in which mental symptoms, particularly paranoid delusions, are transmitted from one person to one or more others with whom the apparent instigator is in some way intimately associated so that he or she and they come to share the same delusional ideas.

Folie a deux wine