Meeting abstract

https://doi.org/10.24869/spsih.2026.304

Folie à Deux: A Case Report of a Patient With Anorexia and Specific Phobias

Katja Galić Ćaleta ; Neuropsychiatric Hospital „Dr. Ivan Barbot“ in Popovača, Jelengradska 1, 44317 Popovača, Croatia *
Ante Silić ; Sisters of Charity University Hospital, Vinogradska cesta 29, 10000 Zagreb, Croatia
Dalibor Karlović ; Sisters of Charity University Hospital, Vinogradska cesta 29, 10000 Zagreb, Croatia
Branka Vidrih ; Sisters of Charity University Hospital, Vinogradska cesta 29, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

Folie à deux, or shared psychotic disorder, is a rare
yet fascinating phenomenon among psychiatric
diagnoses. It is most often seen in people who are
emotionally connected, whether spouses or members
of the primary family, in whom one person
with delusions induces their occurrence in another
person. This case presents a 50‑year‑old man
who, after a divorce and years of living abroad,
returns to Croatia, where he lives with his parents.
Although during the COVID pandemic he
decided to lose weight because of excess body
weight, not knowing his “limits”, he progressed
to cachexia accompanied by extensive edema
that made movement difficult. Although during
endocrinological work‑up he was referred for a
psychiatric evaluation, it is only when he reaches
his lowest body weight that he presents to the Emergency Psychiatric Outpatient Clinic because of suicidal thoughts. On admission, ideas of guilt
are observed that reach a delusional level, with
the patient, despite being in a financially stable
situation, stating that he does not eat out of frugality
and because of his mother’s fear of poverty.
During hospitalization, in individual interviews
with the patient, it is learned that he avoids eating
meat because his mother is convinced that
meat contains bugs and insects that can poison
them. The mother is not in treatment. After introducing
an antipsychotic into therapy, along
with benzodiazepines, an improvement in the
patient’s mental state is observed. After hospitalization,
treatment continues in the Day Hospital,
where he actively participates in group therapy
work, and after individual sessions he gradually
enriches his diet, adding all important nutrients,
including meat products. He shows initiative in
household chores and meal preparation, and an
increase in body weight is recorded. What surprises
everyone is his adherence to taking medication
and to attending group therapy and follow‑up
appointments.

Keywords

shared psychotic disorder; folie à deux; anorexia; suicidality; guilt feelings

Hrčak ID:

352997

URI

https://hrcak.srce.hr/352997

Publication date:

15.6.2026.

Article data in other languages: croatian

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