Analysis of Delusional Statements from 15 Japanese Cases of ‘Folie à Deux’

Vol. 39, No. 2, 2006

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Original Paper

Analysis of Delusional Statements from 15 Japanese Cases of 'Folie à Deux'
Mitsue Shimizu^a, Yasutaka Kubota^b, Joseph R. Calabrese^c, Motomi Toichi^d, Satoshi Kato^e, Hisamitsu Baba^a

^aMedical Center for Student Health/Department of Biosignal Pathophysiology, Graduate School of Medicine, Kobe University, Kobe, Japan;
^bHealth and Medical Services Center, Shiga University, Shiga-ken, Japan;
^cMood Disorder Program, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA;
^dSchool of Health Services, Faculty of Medicine, Kyoto University, Kyoto, Japan, and
^eDepartement of Psychiatry, Jichi Medical School, Tochigi-ken, Japan

Address of Corresponding Author

Psychopathology 2006;39:92-98 (DOI: 10.1159/000090599)

Key Words

Folie à deux
Schizophrenia
Shared psychotic disorder
Delusional disorder
Delusion
Subjectivity
Paranoid
Nonparanoid
Cognitive function
Ego

Abstract

Background: Although many studies have reported folie à deux (FAD) cases, there has not yet been a study systematically examining patients' delusional statements. In the present study, we analyzed the changes in patients' delusional statements across the clinical course from the perspective of discourse analysis. Sampling and Methods: First, we presented a case of FAD in a married Japanese couple. Second, we examined 14 other cases of FAD from Japanese literature and analyzed changes in subjective pronoun (SP) use in each patient's delusional statements. Results: Observed delusions of FAD were classified into the following two categories, based on the SP: (1) We-type: 'We are persecuted', and (2) Non We-type: mostly 'I am persecuted'. Interestingly, We-type was generally observed in paranoid schizophrenia, paranoid disorder, and shared psychotic disorder. In contrast, Non We-type was predominantly observed in nonparanoid schizophrenia. Conclusions: The present classification might reflect two different mechanisms of delusional association in FAD. Possible mechanisms of delusional transmission in schizophrenia were discussed. The present study has a clear limitation in the small number of cases from only Japanese literature. Furthermore, the relatively high occurrence of FAD between married couples in the Japanese literature may have introduced some bias into the present results. Further studies on FAD are needed, however, the present method of examining the SP seems to be useful in order to investigate the psychological mechanism of delusion formation between plural subjects.

Author Contacts

Mitsue Shimizu
Medical Center for Student Health, Kobe University
1-1 Rokkodai-cho, Nada-ku, Kobe 657-8501 (Japan)
Tel. +81 78 803 5245, Fax +81 78 803 5254
E-Mail shimizu@kobe-u.ac.jp

Article Information

Preliminary results were presented at the International Jubilee Congress, of World Psychiatric Association, Paris, France, July 26-30, 2000.

Received: January 29, 2004
Accepted after revision: May 10, 2005
Published online: January 2, 2006
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 4, Number of References : 34

Medline Abstract (ID 16391511)

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