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Yıl:2009; Cilt: 47; Sayı: 2>> Özet
TAM METİN
Yeni Symposium; 2009;47(2):45-51
Hezeyanları ve Hallüsinasyonları Altı Aile Üyesi Tarafından Paylaşılan Bir Paranoid Şizofreni Vak'ası
EMÖ Şahin, ME Sevim, A Belene, E Yurt
Bakırköy Prof. Dr. Mazhar Osman Uzman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi
Paylaşılmış psikotik bozukluk (PPB), ilk kez Lasegue ve Falret tarafından "folie a deux" olarak da adlandırılmış bir bozukluktur. Klinikte nadiren tanınan ve genellikle paranoid bozukluklarla birlikte anılan bu sendrom, endüklenmiş psikoz (endüklenmiş paranoid bozukluk), endüklenmiş psikotik bozukluk, endüklenmiş hezeyanlı bozukluk, çifte delilik olarak da bilinmektedir. O sırada yerleşik bir hezeyanı olan kişi ya da kişilerle yakın ilişki çerçevesindeki bir bireyde hezeyan gelişmesi olarak tanımlanır. Sıklıkla biri dominant (aktif), diğeri pasif iki kişide görülür, ancak esas özneden üç, dört, beş kişiye (folie â trois, folie â quatre, folie â cinq) ve hatta bütün âileye (folie â famille) genişleyebilir.
Paylaşılmış psikotik bozukluğun nâdir görüldüğü bilinmekle beraber, insidans ve prevalansına dair bilgiler azdır ve konuyla ilgili literatür bilgileri vak'a sunumlarıyla sınırlıdır. Bununla birlikte bu sendromun yazarların belirttiklerinden çok daha sık görüldüğü de kesindir. DSM-IV-TR ve ICD tanı kriterleri paylaşılmış psikotik bozukluk için hezeyanların paylaşımını zorunlu kılmakta, hallüsinas-yonların paylaşımı ise tanıda göz önüne alınmamaktadır.
Bu yazıda hezeyan ve hallüsinasyonları altı âile üyesi tarafından paylaşılan bir paranoid şizofreni olgusu literatür ışığında tartışılmakta, tanıda sıkça atlanabilen bu tablonun daha geniş belirtiler yelpazesinde değerlendirlebileceği öne sürülmektedir.
A Case of Paranoid Schizophrenia Whose Delusions and Hallucinations are Shared By Six Family Members
Shared psychotic disorder is a rare condition also known as "folie â deux". This rarely diagnosed clinical entity is usually associated with paranoid syndromes and sometimes named as induced psychosis (induced paranoid disorder), induced psychotic disorder, induced delusional disorder. It is characterized by the development of a delusion or hallucinations in an individual in the context of a close relationship with another person, who already has an established delusion. The disorder is characterized by the transfer of delusions from one person to another and most commonly involves two people, a dominant and a submissive one. Both people are usually in close relationship for a long time and typically live together in relative social isolation. Cases involving more than two individuals are considered to be extremely rare and have been called folie a trois, folie a quatre, folie a cinq, folie famille and so on. The case to be presented here is about a female patient diagnosed as schizophrenia (paranoid type) according to the DSM-IV diagnostic criteria and whose delusions and hallucinations are shared by six family members.
We suggest that delusions are not the only symptom cluster to be shared in "shared psychotic disorder"... it should be kept in mind that a broader symptom scale might be involved in such disorders as well as a wider number of people.

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