Nielssen Olav, Langdon Robyn, Large Matthew
a Clinical Research Unit for Anxiety and Depression , St. Vincent's Hospital , Sydney , Australia.
Cogn Neuropsychiatry. 2013;18(5):390-408. doi: 10.1080/13546805.2012.718246. Epub 2012 Sep 14.
Cases of folie à deux resulting in homicide challenge traditional definitions of delusions. Secondaries who abandon their beliefs soon after separation from a primary raise doubts about the status of their delusional beliefs at the time of the offence. In this paper, we apply the "two-factor" model of delusions to a series of cases of folie à deux resulting in homicide.
A retrospective analysis of five cases.
The primary affected person appeared to be the source of the delusional content in each of the cases. Impairment of belief evaluation was evident to some degree in all patients. There appeared to be a range of underlying causes of impaired belief evaluation. The transitory nature of the reported beliefs in some secondary cases suggested that they were due to motivational rather than neuropathological mechanisms. Social isolation contributed to the inability to critically appraise beliefs in most cases.
The two-factor model is a useful method to contrast the emergence of a shared delusional belief in primary and secondary patients with folie à deux. Folie à deux demonstrates the need to consider the exogenous source of delusional content in many patients.
二联性精神病导致杀人的案例对妄想的传统定义提出了挑战。与主犯分离后很快放弃其信念的从犯，引发了对其在犯罪时妄想信念状态的质疑。在本文中，我们将妄想的“双因素”模型应用于一系列二联性精神病导致杀人的案例。
对五个案例进行回顾性分析。
在每个案例中，主犯似乎都是妄想内容的来源。所有患者在某种程度上均明显存在信念评估受损的情况。信念评估受损似乎存在一系列潜在原因。一些从犯案例中所报告信念的短暂性表明，它们是由动机而非神经病理机制所致。在大多数案例中，社会隔离导致无法批判性地评估信念。
双因素模型是一种有用的方法，可用于对比二联性精神病主犯和从犯中共同妄想信念的出现情况。二联性精神病表明，在许多患者中需要考虑妄想内容的外部来源。
