The delusional parent: family and multisystemic issues.
OBJECTIVE
To examine the dilemmas for children, family, and mental health professionals posed by the presence of a delusional parent in a family, including someone with induced psychotic disorder (IPD); to identify frequently unrecognized problems; and to propose practical suggestions for professionals.


METHODS
The pertinent literature on the effects of delusional parents on children, families, and professionals is reviewed. By way of 3 case vignettes, the dilemmas are identified and discussed.


RESULTS
Delusional disorders are underdiagnosed, resulting in poor anticipation of their implications. Unanticipated family factors, such as "pursuit of isolation" and the related heightened risk of violence, contribute to the failure of professional interventions, which has been described as "therapeutic systems paralysis."


CONCLUSIONS
These cases are complex, often requiring multisystemic involvement to reduce the risks of flight. violence, psychosis, posttraumatic stress disorder, and other psychiatric sequelae to children and other family members. The critical features of the innovative collaboration ("therapeutic consensus") required between professionals for successful therapeutic interventions with these families are described.
Ulzen
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TP
George Hull Centre for Children and Families, Etobicoke, Ontario.
Carpentier
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D000293:Adolescent; D000328:Adult; D002648:Child; D002669:Child Welfare; D016241:Child of Impaired Parents / Q000523:psychology*; D003702:Delusions / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D017579:Domestic Violence / Q000517:prevention & control / Q000523:psychology; D005190:Family / Q000523:psychology*; D005196:Family Therapy; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008297:Male; D010259:Paranoid Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010290:Parents / Q000523:psychology*; D010348:Patient Care Team; D010553:Personality Development; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D012307:Risk Factors; D012753:Shared Paranoid Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D012934:Social Isolation; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy