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  #1  
Old 07-28-2012
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Psyche Folie à Deux Case Scenario!

You are seeing a 41 year-old woman and her 19 year-old daughter in the emergency room because they think that they have been poisoned. The woman states that they have not been getting along with their landlord lately because they have been late on their last few rent payments. They say that the landlord is harassing them by banging on their floor at all hours of the night, turning down their heat, and asking the other tenants to spy on them . Last month, the woman thinks the landlord tried to spy on them by installing video cameras in her living room while they were out. Today, she tasted something odd in her food, and is convinced that she and her daughter have been poisoned in an attempt to get them out of the apartment once and for all. She came immediately to the hospital for treatment and to collect evidence of the poisoning. The mother is very protective of her daughter, who seems rather submissive and passive. She completely agrees with her mother's description of the events.

Which of the following is the best course of action?

A. Discharge both the mother and the daughter after a complete physical examination and blood tests.
B. Admit the mother to the psychiatric unit for treatment, but not the daughter.
C. Admit the daughter to the psychiatric unit for treatment, but not the mother.
D. Admit the mother and the daughter to the same psychiatric unit.
E. Admit the mother and the daughter to different psychiatric units.


*** does daughter need admission in this case ? why or why not ?
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  #2  
Old 07-28-2012
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She completely agrees....she too needs admission but diff units
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Old 07-28-2012
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I recall this answer, I had gotten it right (not blowing my horn).

Basically, the mother is rubbing off on her daughter, and you have to separate them to determine if there is in fact any truth to the matter or any pathology.

Same principle as in criminal investigations when you separate 2 criminals and tell them the other has squealed, the other will start telling the truth so you can determine who actually is at fault.
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B. Admit the mother to the psychiatric unit for treatment, but not the daughter.

Doesn't sound like a typical case of folie a deux but more of a delusional disorder of mother and dependent personality disorder of daughter.
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E. Admit the mother and the daughter to different psychiatric units.

Quote:
Various sub-classifications of folie à deux have been proposed to describe how the delusional belief comes to be held by more than one person.

Folie imposée is where a dominant person (known as the 'primary', 'inducer' or 'principal') initially forms a delusional belief during a psychotic episode and imposes it on another person or persons (known as the 'secondary', 'acceptor' or 'associate') with the assumption that the secondary person might not have become deluded if left to his or her own devices. If the parties are admitted to hospital separately, then the delusions in the person with the induced beliefs usually resolve without the need of medication.

Folie simultanée describes either the situation where two people considered to suffer independently from psychosis influence the content of each other's delusions so they become identical or strikingly similar, or one in which two people "morbidly predisposed" to delusional psychosis mutually trigger symptoms in each other.[3]
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Old 07-29-2012
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The correct answer is
Interview the daughter when the mother is not present.
This is UWORLD QID 4888

@tyagee Why would you post an incomplete questions
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i will go with E
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Quote:
Originally Posted by Gastrin View Post
The correct answer is
Interview the daughter when the mother is not present.
This is UWORLD QID 4888

@tyagee Why would you post an incomplete questions
this is from offline qbank. so they must have updated it. not posting incomplete questions . thank you.
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E different psychiatrist
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Quote:
Originally Posted by Gastrin View Post
The correct answer is
Interview the daughter when the mother is not present.
This is UWORLD QID 4888

@tyagee Why would you post an incomplete questions

Wait, how is it incomplete? Its exactly the same as the one on Uworld..
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I meant without the correct answer option
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Old 07-31-2012
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Quote:
Originally Posted by Gastrin View Post
I meant without the correct answer option
Well, my friend, I see where you're getting at but IMHO, It is not an incomplete question, going through it with an open mind you'd quickly realize that
'E' is the correct option!
You see, In these "folie a deux" cases, the right management would be to initially admit the two patients ( mother and daughter in this case) to "different psychiatric units", the idea being to separate the two individuals, and it doesn't work as quickly as to just by asking the mother to step-out of the office, The two have to be separated for some time for the delusion to be fade away!
Correct me if I'm wrong, look forward to your reply...
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@tyagee - thank you for posting this Q but would you please label the Qs indicating the source... coz i havent started uworld yet and dont wanna miss my surprise..lol... a sincere request, plz... thank you...
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Quote:
Originally Posted by ..sharma View Post
@tyagee - thank you for posting this Q but would you please label the Qs indicating the source... coz i havent started uworld yet and dont wanna miss my surprise..lol... a sincere request, plz... thank you...
It's pretty hard. Sources vary and when I collect them it becomes hard mentioning source. I don't post nbme q.

As of personal note. It's nice participating. Many q hv twist which are worth revising.

Thank u.
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