That is when the family members brought them to psychiatrist for treatment.
Hospital course At the time of admission, “A” and “B” were very agitated, uncooperative, unkempt, and untidy.
One week back, the duo went to the city, they believed “X” lives in and started searching for him for days.
The family members searched for them and found them wandering here and there in shaggy unwashed clothes, no slippers, and not taken proper meal in past 2 days.
Electro-convulsive therapy was also given, although complete documentation was not available.
“A,” married at the age of 25, had divorce at 28 (reason as per informants were frequent quarrels).According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), the diagnosis of shared psychotic disorder is made if “a delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion, similar in content, not better accounted for by another psychiatric/medical/substance-induced disorder.” If criteria are met for delusional disorder, then same diagnosis is made.If the diagnosis cannot be made, but shared beliefs are present, then the diagnosis “other specified schizophrenia spectrum and other psychotic disorder” is used.A battery of tests were done on the duo to rule out general medical conditions as a potential cause of delusions.In pharmacotherapy, “A” was given clozapine, its dose was titrated till 150 mg divided in bd doses. The duo did not show any improvement in first 2 weeks and refused to meet any of their relatives. In third week, after separation and psychotherapy, their agitation somewhat decreased, but still their delusions were unshaken.In the paradigm of changing nosology, where the term shared/induced psychotic disorder is going obsolete, it is important to recognize such cases due to the potential for recovery in the submissive partner.Here, we present a case report and discussion of folie a deux involving inducer mother and induced daughter.Six months back, “A” discontinued her treatment and for past 3 months, confided her daughter “B” and herself to home, and threatened her own mother to leave the home.“A” had no contact with any of other family members, since then.Her daughter “B” also came with her mother, both were blaming their relatives for forceful psychiatric consultation and not leaving each other's side, even for a minute.As per the given information and documents shown by relatives, “A” had her first episode of psychotic illness at the age of 20.