Page 22 - Delaware Medical Journal - May/June 2020

Paranormal Activity Explained by Traits of Munchausen Syndrome By Proxy and Folie à Deux
Omar Shah, MD; Mary Diamond, DO; Gerard Gallucci, MD, MHS
INTRODUCTION
Factitious disorder imposed on another (FDIA), formerly known as Munchausen syndrome by proxy, is a term used to describe a mental illness where an individual imposes or attributes a mental or physical illness to a person who they are caring for when the person is not really ill.1 Folie à deux is a psychiatric condition where an individual shares symptoms such as delusions and hallucinations with another person.2 A common feature of both FDIA and folie
à deux is that the symptoms seen in one person have been induced actively or passively by another person or group of persons. In FDIA, it is often the caregiver, especially the mother, who induces an illness or imposes it on an individual;
in folie à deux, the more dominant
person imposes their own symptoms on another person. The beliefs assigned to the symptoms in folie à deux are often delusional in nature and not characterized as legitimate, or simply hysterical or based on a culturally shared belief system. Both syndromes present challenges for diagnosis and treatment.3-5
CASE
The patient was a 12-year-old white male with a history of aggression, anxiety,
and mood instability, who was admitted to the Crisis Unit for observation and safety. The patient and his family reported one year ago after he was “possessed by beings that were haunting the home.” The
family stated they were convinced that the home was haunted and they detailed
a number of occurrences to support this belief. They said the patient and others had experienced a number of disturbing events, including the dragging of the sounds, doors locking and unlocking spontaneously, “beings” kicking and scratching the patient and family members, invisible hands choking the patient, and other unusual occurrences on a daily basis for the past year.
These experiences led to the patient feeling depressed and anxious, and resulted in problematic behaviors including anger outbursts, aggression directed toward family members, nightmares, and purging and vomiting behaviors by the patient and concerns
118
Del Med J | May/June 2020 | Vol. 92 | No. 3