Shared psychotic disorder
Chapter 5:Mental, Behavioral and Neurodevelopmental disorders
ICD-10 F24 is a billable code used to indicate a diagnosis of shared psychotic disorder.
Shared psychotic disorder, also known as folie à deux, is a rare psychiatric syndrome where a delusional belief is shared between two or more individuals, typically involving a dominant partner who has a primary psychotic disorder, such as schizophrenia, and a submissive partner who adopts the delusional beliefs of the dominant individual. The condition often arises in close relationships, such as between family members or partners, and can manifest in various forms, including shared delusions of persecution, grandeur, or other themes. Diagnosis requires careful clinical assessment to differentiate it from other psychotic disorders, particularly those within the schizophrenia spectrum. Treatment typically involves separating the individuals involved, providing antipsychotic medications to the dominant partner, and offering supportive therapy to both parties. Functional assessment is crucial, as the impact of shared delusions can significantly impair social and occupational functioning. The prognosis varies, with some individuals recovering fully after separation, while others may continue to experience psychotic symptoms.
Comprehensive psychiatric evaluation, including history of present illness, mental status examination, and functional assessment.
Evaluating a couple presenting with shared delusions, assessing family dynamics in a clinical setting.
Understanding the impact of the relationship on the presentation of symptoms and treatment adherence.
Detailed history taking, including psychosocial factors and family history.
Identifying shared psychotic disorder in a family setting during routine check-ups.
Recognizing the signs of shared delusions in patients and their family members.
Used for therapy sessions with individuals experiencing shared psychotic disorder.
Document the duration of the session and the focus on delusional beliefs.
Psychiatrists should note the dynamics of the relationship in therapy.
The primary treatment involves separating the individuals involved, administering antipsychotic medications to the dominant partner, and providing supportive therapy to both parties.
