Bout Amine, Berhili Nabil, Hlal Hayat, Aalouane Rachid, Rammouz Ismail
Service de Psychiatrie, Centre Hospitalier Universitaire Hassan II, Fès, Maroc.
Pan Afr Med J. 2019 Jan 28;32:47. doi: 10.11604/pamj.2019.32.47.8378. eCollection 2019.
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.
共享性精神病性障碍或感应性精神病是一种罕见且存在争议的病症,引发了现象学、疾病分类学和精神病理学等方面的问题。它对妄想的本质及其在精神病结构之外的发生情况提出了质疑,同时也涉及到精神病学中症状传染的问题。我们对一例家族性感应性精神病病例进行了症状学分析,该病例不仅共享妄想症状,还共享非妄想性精神病性成分,具有临床特殊性。接着,我们深入探究其流行病学特征以及与文献中不同文化背景下其他已报道病例的共同因素。然后,我们梳理了该病症自勒格兰首次描述以来至《精神疾病诊断与统计手册》第5版的分类历史及其演变。在此基础上,我们强调纯粹描述性方法的不足,并关注其与其他在两个或更多人之间更常见的精神症状传递临床情况的可能联系。最后,我们提出一种精神病理学思考,主要针对症状的共享而非其本质,同时对妄想性伴侣关系中妄想的功能提出质疑。