Induced psychotic disorder: clinical aspects, theoretical considerations, and some guidelines for treatment.

We describe our experience with a case of folie à famille with role reversal, including the long-term course. In addition, the case reports published since 1974 were reviewed and an overview is given of the psychoanalytic and system theory concepts on the pathogenesis of induced psychotic disorder. The inductor often appears to be suffering from schizophrenia. No further indications could be found in the literature for a hereditary predisposition in the recipient. It is sometimes difficult to distinguish between the inductor and the recipient, owing to the circular character of induced psychotic disorder and the role reversal that sometimes occurs. The DSM-III-R criteria for induced psychotic disorder were found to be lacking in practice because of their disregard for the circular causality and the strict exclusion criteria. In the short term, physical separation of the inductor and recipient leads to better treatment results than nonseparation, particularly in the case of recipient children. Long-term results are seldom mentioned. On the basis of theoretical considerations, interventions that aim at separation in psychological terms are necessary to achieve favorable long-term treatment results.