Folie à deux and Fregoli syndrome with greater severity in the 'secondary' - A case report

Folie à deux and Fregoli syndrome are rarely seen in clinical practice. We present a case in which these rare syndromes co-occur. Remarkably, in this case the 'secondary' develops a more serious illness course than the 'primary' and reciprocally induces a de novo Fregoli delusion in the 'primary'. This case discusses how socio-cultural factors, such as interdependent family dynamics, could have precipitated this rare variant of folie à deux. It also highlights the importance of making culturally-sensitive formulations for treatment.