Shared obsessive-compulsive disorder: broadening the concept of shared psychotic disorder

Folie a deux (shared psychotic disorder) is often described in the context of schizophrenia. In this article we present this syndrome in a non psychotic context.

We report a case of induced obsessive-compulsive disorder (OCD) in a married couple. Six months after the deterioration in the patient's OCD, his wife developed the same symptoms with no preceding history of an Axis I disorder. Neither spouse demonstrated psychotic symptomatology. The husband was successfully treated on an outpatient basis with Citalopram and Clonazepam. His wife's OCD spontaneously resolved without medication in parallel with the resolution of her husband's OCD.

We highlight the uncommon phenomenon of shared psychiatric disorder occurring in the context of OCD. In the current psychiatric diagnostic nomenclature, (DSM IV and ICD10), there is no category for a non-psychotic shared psychiatric disorder. We raise the question of broadening the concept of shared disorder so as to include shared OCD and perhaps other shared psychiatric syndromes.

More controlled studies are required in order to better understand the psychopathology and mechanisms of psychotic and non-psychotic shared disorders in psychiatry. We believe there are important treatment implications of such an understanding.