Mr Dayal is a 55year, senior government official; he is admitted to a general hospital for treatment of head injury. He was attacked by his wife and son 2 days back .Mrs. Dayal is a 50year woman was brought to Tulasi Rehab Centre by her brother. She was very disturbed, agitated, and restless. Her looks were disheveled and she made no eye contact. When she was questioned by the psychiatrist about her problems, she blamed her husband of having an affair and she also thought that he was trying to kill her. She was convinced that he wanted her dead so that he could continue with his affair .She has a son 18 year old boy, who on interviewing also shared a similar view about his father. He also believed that his father was having an affair and was targeting him and his mother. Mrs.Dayal brother was also interviewed; he informed the doctor that she was a patient of paranoid schizophrenia since last 15 years. She did not take medicine regularly and was violent with her husband from time to time.
Family had tried to get her treated but all their efforts had been fruitless. Since last 5years there was deterioration in the son’s behavior towards the father and he was also aggressive towards him .Mrs Dayal was admitted for treatment of paranoid schizophrenia. She was started on anti psychotic medicines. The son was separated from the mother and underwent counseling sessions. He was able to recognize the false belief system he had developed. He was sent out of Delhi for higher studies and was soon overcame his delusion and was able to restore relationship with his father.
Mrs Dayal and her son were diagnosed to have Shared Psychotic Disorder .This is a condition where a healthy person shares the delusion of a psychotic person. The first case is called the secondary case and the second is the primary case. The delusions are induced in the secondary cases which usually disappear when both are separated. This disorder is seen in long term relationships in which one person is dominant and other is passive. Generally the people involved are isolated and have a close emotional link. The cause of shared psychotic disorder is unknown but social isolation and stress plays a role in its development.
Basically 3 important symptoms are required to make the diagnosis
- An otherwise healthy person is in a close relationship with someone who already has an established delusion and develops a delusion himself/herself.
- The content of the shared delusion follows exactly or closely resembles that of the established delusion.
- Psychotic disorder, such as schizophrenia not found in the secondary case
The treatment recommended is to separate the secondary partner from the source of the delusion. The primary case has to be started on anti psychotic medicines. If the secondary case symptoms do not disappear, anti psychotic medication may be considered. Prognosis is good if the partners are separated and do not reunite. Psychotherapy for the secondary partner is most important for him or her to realize the existence of delusions.