obsolete shared paranoid disease

Shared Paranoid Disorder: An Obsolete Diagnosis

Shared paranoid disorder, also known as folie à deux, was a rare psychiatric condition in which an individual with a psychotic disorder would transfer their delusional beliefs to another person, often a family member or close associate. This condition was characterized by the sharing of a delusion among two or more people in a close relationship.

Key Features

• A primary case (the individual with the psychotic disorder) transfers their delusional beliefs to a secondary case (the healthy individual)
• The delusions are shared between the two individuals, often with the secondary case adopting the delusions of the primary case
• The condition is typically seen in close relationships, such as family members or romantic partners

Diagnostic History

Shared paranoid disorder was first identified by Marandon de Montyel in 1881 and was later included in various psychiatric diagnostic manuals. However, it has since been removed from these manuals due to its rarity and the lack of clear diagnostic criteria.

• DSM-I (1952) listed shared paranoid disorder as a separate diagnosis
• DSM-II (1968) retained this classification
• DSM-III (1980) renamed it to shared psychotic disorder
• DSM-IV (1994) continued to list it as a separate diagnosis, but with the name changed again to shared psychotic disorder
• DSM-5 (2013) removed shared psychotic disorder from the diagnostic manual altogether

Current Understanding

While shared paranoid disorder is no longer considered a distinct psychiatric condition, the phenomenon of delusional transmission between individuals in close relationships remains an area of interest for researchers. The current understanding is that this type of delusional transmission can occur in various forms of psychosis, including schizophrenia and other psychotic disorders.

References:

• [1] Marandon de Montyel's original description of folie à deux (1881)
• [2-5] Various DSM revisions that listed shared paranoid disorder as a separate diagnosis
• [6] Current understanding of delusional transmission in psychosis

Based on the provided context, it appears that there are several conditions related to paranoia that have been considered in the past or are still being studied.

• Undifferentiated schizophrenia: This is an outdated term for a type of schizophrenia where a person meets the criteria for the disorder but cannot be classified into just one of its four subtypes. While this term is no longer listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), some healthcare providers still use it [3].
• Paranoid personality disorder: This mental health condition is marked by a long-term pattern of distrust and suspicion of others without adequate reason to be suspicious (paranoia). People with this disorder often believe that others are trying to demean, harm or threaten them [13].
• Delusional disorder (persecutory type): This disorder is characterized by episodes of psychotic symptoms, such as delusions and hallucinations, where a person believes they are being persecuted or harmed by others. It can be distinguished from paranoid personality disorder because the episodes of psychotic symptoms are prominent in this disorder [15].

It's worth noting that paranoid schizophrenia was removed from the list of official diagnoses when updating the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) in 2013, and also removed from the International Classification of Diseases when updating to the 11th edition (ICD-11) in 2019 [1].

The signs and symptoms of these conditions can include:

• Distrust and suspicion of others
• Paranoid delusions
• Hallucinations
• Disorganized thoughts and speech
• Unusual behavior
• Withdrawal

These symptoms can be prominent in various disorders, including schizophrenia, schizoaffective disorder, schizophreniform disorder, and delusional disorder (persecutory type).

References: [1] The American Psychiatric Association removed paranoid schizophrenia from the list of official diagnoses when updating the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), published in 2013. [3] Undifferentiated schizophrenia is an outdated term for a type of schizophrenia in which a person meets the criteria for the disorder but cannot be classified into just one of its four subtypes. [13] Paranoid personality disorder can be distinguished from delusional disorder (persecutory type), schizophrenia, and a depressive disorder or bipolar disorder with psychotic features because in these disorders, episodes of psychotic symptoms (eg, delusions, hallucinations) are prominent. [15] Paranoid personality disorder can be distinguished from delusional disorder (persecutory type), schizophrenia, and a depressive disorder or bipolar disorder with psychotic features because in these disorders, episodes of psychotic symptoms (eg, delusions, hallucinations) are prominent.

Based on the provided context, it appears that the diagnostic tests for "shared paranoid disorder" (also known as "folie à deux") are not specifically mentioned in the search results.

However, according to result [10], the DSM-III-R replaced the term "paranoid disorders" with "delusional (paranoid) disorder", and there is no mention of specific diagnostic tests for shared paranoid disorder.

Result [15] mentions that there are no lab tests that specifically diagnose shared psychotic disorders, but rather doctors may use tools such as brain imaging (including MRI scans) and blood tests to rule out other causes.

It's worth noting that the term "shared paranoid disorder" is considered obsolete, and the current terminology used in the field of psychiatry is "shared psychotic disorder" or "folie à deux".

Diagnostic Tests:

• None specifically mentioned for shared paranoid disorder
• May use brain imaging (including MRI scans) and blood tests to rule out other causes

References:

[10] - DSM-III-R replaced the term "paranoid disorders" with "delusional (paranoid) disorder" [15] - No lab tests specifically diagnose shared psychotic disorders

The treatment of shared paranoid disorder, also known as folie à deux, has evolved over time and involves a range of approaches.

Historical Context In the past, antipsychotics were shown to be effective in treating positive symptoms of psychosis, such as delusions and hallucinations [1]. However, with the removal of paranoid schizophrenia from official diagnoses (DSM-5 and ICD-11), the treatment landscape for shared paranoid disorder has shifted.

Current Treatment Options While there is no specific treatment for shared paranoid disorder, various approaches can be used to manage symptoms:

• Psychotherapy: Counseling can help individuals recognize delusions and develop healthy thinking patterns [12].
• Antipsychotics: Although not specifically indicated for shared paranoid disorder, antipsychotics may still be effective in treating positive symptoms of psychosis [1].
• Alternative treatment-regimes: Some evidence suggests that alternative treatments, such as clomipramine, may be considered beyond conventional antipsychotic therapy [8].

Precision Medicine Approaches In cases of treatment resistance, precision medicine approaches can be used to stratify treatment for schizophrenia. However, this remains an underutilized resource [15].

It's essential to note that the primary goal of treatment is to address the underlying delusional disorder in the individual with shared paranoid disorder.

References:

[1] A González-Rodríguez (2022) - Antipsychotics were shown to be very effective in treating positive symptoms of psychosis [22]. [8] by N Dhaka (2016) - Shared paranoid disorders, a relatively rare psychiatric disorder... [12] Treatments for the person with the shared psychotic disorder might include: Psychotherapy... [15] Treatment teams should balance between shared decision-making and motivational interviewing to address these goals.

The differential diagnosis for the obsolete shared paranoid disorder, also known as folie à deux, involves ruling out other causes such as drug-induced conditions, dementia, infections, metabolic disorders, and endocrine disorders [4]. This is crucial in distinguishing it from other psychiatric conditions.

In the past, when diagnosing shared paranoid disorder, clinicians would consider the following:

• Shared psychotic disorder (folie à deux): A rare condition where two or more people in a close relationship share a delusion. The inducer has a psychotic disorder with delusions, which influences another nonpsychotic individual [10].
• Paranoid schizophrenia: A type of schizophrenia characterized by paranoia, delusions, and hallucinations [9]. However, this diagnosis was deemed outdated in 2013 and now falls within the scope of schizophrenia.
• Dissociative disorders: Conditions that involve a disconnection between thoughts, identity, or consciousness. In some cases, differential diagnosis with dissociative disorders can be close, especially when considering the presentation of symptoms [12].

The American Psychiatric Association removed paranoid schizophrenia from the list of official diagnoses in 2013, and the World Health Organization removed it from the International Classification of Diseases in 2019 [15].