Socio-Clinical Substrates of Folie à Deux

¹ Consultant Psychiatrist, Prestwich Hospital, Prestwich, Manchester, M25 7BL

Eight cases of folie à deux seen at Prestwich Hospital are presented in this paper. A relevant review of the literature in conjunction with these cases suggests that whereas the principal in folie à deux is always a psychotic who initiates the delusions on the basis of his morbid psychotic illness, the associates have an assortment of abnormalities including schizophrenia, subnormality, susceptible personality and dementia which predispose them to acquire the delusions of their partners. The social milieu is considered as a determinant of the actual content of the delusional systems, and precipitant in some cases. It is the opinion of the authors that such a socio-clinical approach in folie à deux can be rewarding both prognostically and therapeutically.