Shared Psychotic Disorder: Understanding Symptoms, Risk Factors, Diagnosis, Treatment, and Coping

What is Shared Psychotic Disorder?

Shared psychotic disorder is a rare mental illness in which an individual, referred to as the secondary person, develops delusions similar to those of another person, known as the primary person, who has a psychotic or delusional disorder. The secondary person, despite having no primary mental health disorder, comes to believe the delusions of the primary person. This condition was first identified in 1860 and has been known by various terms over time.

Symptoms of Shared Psychotic Disorder

The symptoms of shared psychotic disorder can vary depending on the specific diagnosis of the primary person with the disorder. However, there are some common features observed across cases:

• Secondary Effects: Living with delusions can have an impact on both physical and mental health due to increased stress and fear. Secondary mental health issues such as anxiety and depression may develop.

• Primary Symptoms: Neither the primary person with the mental illness nor the secondary person who develops the same delusions has insight into the problem or awareness that their beliefs are not based on reality.

• Delusions: Delusions are a core symptom of shared psychotic disorder. They can be bizarre (physically impossible) or non-bizarre (possible but highly improbable). Delusions may also be mood-congruent, meaning they match the mood state of the primary person (e.g., depressed or manic).

• Behavioral Changes: Both individuals may exhibit paranoid, fearful, and suspicious behavior. They may become defensive or angry if their delusions are challenged. Grandiose delusions may lead to euphoric behavior.

• Relationship Dynamics: The primary person in the relationship typically does not recognize their role in causing the illness in the secondary person. They believe they are simply sharing the truth with them. The secondary person may exhibit dependent personality traits, fear, and a need for reassurance.

Causes of Shared Psychotic Disorder

The exact causes of shared psychotic disorder are not fully understood, but several risk factors have been identified:

• Social Isolation: Isolation of the primary and secondary person from the outside world can contribute to a lack of social comparison and make it difficult to distinguish between fact and delusion.

• Chronic Stress: High levels of chronic stress or stressful life events can increase the risk of developing shared psychotic disorder.

• Power Dynamics: A relationship dynamic with a dominant primary person and a submissive secondary person may contribute to the development of the disorder.

• Close Connection: A close connection between the primary and secondary person, often a long-term relationship with attachment, is commonly observed in cases of shared psychotic disorder.

• Personality Traits: The secondary person may have a neurotic, dependent, or passive personality style or struggle with judgment and critical thinking.

• Mental Health History: The secondary person may have a personal or family history of mental illness, making them more susceptible to developing shared psychotic disorder.

• Untreated Primary Disorder: An untreated disorder, such as delusional disorder, schizophrenia, or bipolar disorder, in the primary individual can contribute to the development of shared psychotic disorder.

Diagnosis of Shared Psychotic Disorder

Diagnosing shared psychotic disorder can be challenging due to its rarity and the lack of insight from both individuals involved. The diagnosis is typically made based on the following criteria:

• Clinical Interview and Medical Exam: A thorough clinical interview and medical exam are conducted to rule out other medical conditions or substance abuse that could be causing the symptoms.

• Mental State Examination: A mental state examination is performed to assess the individual's thoughts, beliefs, and behaviors.

• History from a Third Party: Information from a third party, such as a family member or friend, may be obtained to ensure accuracy in the reported symptoms and behaviors.

Treatment of Shared Psychotic Disorder

Due to the rarity of shared psychotic disorder, there is no standard treatment protocol. Treatment typically involves a team approach that may include a doctor, nurse, pharmacist, and mental health professionals. The primary goal of treatment is to reduce the delusions and improve the overall mental health of both individuals.

• Separation: Initially, the secondary person may be separated from the primary person to reduce the influence of the delusions.

• Psychotherapy: Psychotherapy, such as cognitive-behavioral therapy (CBT) or family therapy, can help ease emotional turmoil, shed light on dysfunctional thinking patterns, and promote healthy social relationships.

• Medication: Depending on the symptoms of each individual, medication such as antipsychotics, tranquilizers, antidepressants, or mood stabilizers may be prescribed.

Coping with Shared Psychotic Disorder

Coping with shared psychotic disorder can be challenging, but there are steps that can be taken to manage the condition and improve overall well-being:

• Adhere to Treatment: It is essential to adhere to the prescribed treatment protocol, including medication and therapy.

• Build a Strong Therapist Relationship: Establishing a trusting relationship with a therapist is crucial for the success of treatment.

• Avoid Isolation: Maintaining social connections outside the affected relationship can help provide support and perspective.

• Seek Professional Help: If you suspect that you or someone you know is living with shared psychotic disorder, reaching out for professional help is vital.

Conclusion

Shared psychotic disorder is a rare but serious mental illness that can significantly impact the lives of both individuals involved. Early recognition, diagnosis, and treatment are essential for improving outcomes. If you suspect that you or someone you know may be experiencing symptoms of shared psychotic disorder, seeking professional help is the first step towards recovery. With appropriate treatment and support, it is possible to manage the condition and improve overall mental health.