Case report of Folie à Trois

SUMMARY: A 50-year-old factory worker was admitted to hospital following an altercation with fellow workers. He reported a 25-year history of grandiose delusions related to being a special agent for the Taiwanese and US governments (for which he had been paid 100 million dollars) and paranoid delusions related to persecution by China's national security agencies. After detailed assessment by several specialists he was diagnosed as having paranoid schizophrenia. His 48-year-old wife stated that his reports of working as a secret agent were true and that she herself was under scrutiny by the security forces. His 26-year-old son (who was unmarried and still lived with his parents) reported that his father was a ‘Great Man’ with special abilities who was unfairly persecuted and stated that he, too, had been secretly followed. The delusions reported by the wife and son were judged to be induced by those of the patient and so this was determined to be a case of Folie à Trois. After one week of treatment with risperidone – which did not influence the patient's delusional system – he was removed from hospital by his wife and stopped treatment. Three months later the three family members continued to believe that the reported events were true.