Dergi Ara >>
Yıl:2009; Cilt: 20; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2009;20(3):299-304
Akrabalık İlişkisi Olmayan İki İnsan Arasında Paylaşılmış Psikoz
AK Jana, SK Praharaj, S Sarkar, KN Dotivala, G Chabungbam
Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, Hindistan
Paylaşılmış psikoz bir kişinin sanrılarının yakın ilişki içindeki, genellikle kan bağı ya da eş durumunda olan, başka bir kişiye aktarılmasıyla ortaya çıkan ve ender rastlanan bir durumdur. Bu makalede bulaştırılmış deliliğe benzeyen, 37 yaşında, erkek bir paylaşılmış psikoz olgusu ele alınmıştır. Sanrılar, olguya kendisiyle kan bağı olmasa da, duygusal olarak çok yakın olan yaşça büyük bir kadından (birincil olgu) aktarılmıştır. Olgu ve birincil olgu duygusal anlamda çok yakın olup, birincil olgunun doğaüstü güçlere sahip olduğuna dair büyüklük sanrıları ve iş arkadaşlarına ilişkin kötülük görme sanrıları gibi ortak özellikleri vardır. İkincil olguda garip kıyafetler giyme, tuhaf takılar takma ve öz-bakımını ihmal etme gibi bazı davranış değişiklikleri gözlenmiştir. İkincil olgu, birincil olgu ile aynı törensel davranış ve alışkanlıkları izlemeye başlamış ve ergenlikten bu yana sürdürdüğü dini ibadetlerini değiştirmiştir. Kişisel ve mesleki konular dahil olmak üzere vereceği her kararda birincil olgunun fikrini almaya başlamıştır. Bunun yanı sıra, olgular toplumdan uzak değil, şehrin iyi bilinen yerleşim bölgelerinden birinde bir apartman dairesinde yaşamışlardır. İkincil olgu hastalığın ilerleyen aşamasına kadar ofisinde düzenli olarak çalışmaya devam etmiştir. Hastalık öncesi dönemde, ikincil olguda bağımlılık veya düşük zekâya ilişkin bir özellik görülmemiştir. Birincil olgudan ayrılmasının ardından, risperidon tedavisinden (günlük 6 mg) 7 hafta sonra gelişme kaydedilmiştir.
Folie á Deux Between Two Unrelated Individuals
Folie à deux is a rare condition characterized by transmission of delusions from a primary patient to another individual, usually a blood relative or spouse, while living in relative isolation. We report a case of folie à deux, which resembled folie communiquée, in a 37- [year]-old man that acquired it from an older woman (primary patient). Although not related by blood, the patient was emotionally very close to the woman and they shared common features, including grandiose delusions about the supernatural powers of the primary patient and persecutory delusions concerning office colleagues, as the woman had, and then neighbors, fellow villagers, and even family members. Behavioral changes were observed in the secondary patient as he started wearing strange clothing and peculiar ornaments, and neglected his personal hygiene. He also started following the same rituals and routines as the primary patient, and changed his religious practices, which he had followed devoutly since adolescence. He began seeking her opinion concerning almost all decisions he had to make, including personal and professional matters. Yet, unlike the usual clinical picture, they did not live in social isolation; rather, they lived in an apartment in a well-known residential area of the city and he regularly worked at his office until the late stage of illness. Premorbidly, there were no features suggestive of dependency or low intelligence in the secondary case. After separation from the primary case, improvement was observed about 7 weeks after beginning risperidone treatment (6 mg/day).

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