title: All Alone Together: Case Report of Folie à Trois With Schizoaffective and Negative Symptoms in Monozygotic Triplets.
abstract: We present a case of folie à trois with schizoaffective and negative symptoms in monozygotic triplets, which to our knowledge is unique. For 4 years starting in their late teens, the 3 male siblings withdrew socially, adopted a primitive lifestyle, and exhibited poor self-care with increasing aggression, which led to their admission to the hospital at the age of 22 years. Over the subsequent 8 years, 1 brother recovered fully with treatment, resumed academic and social functioning, and does not need medication therapy currently. The other 2 brothers have disengaged from clinical care and moved back in together, following a socially isolated, disengaged way of life. They have relapsed gradually, displaying their previous symptomatology of suspiciousness, grandiosity, irritability, and affective flattening. This case demonstrates that shared psychosis can merge with endogenous psychopathology, including negative symptoms, in the context of genetic susceptibility. In closely associated individuals, such phenomena may go unnoticed or be misinterpreted, and therefore not receive appropriate management. In such a situation, separation as a part of the treatment plan should be approached gradually in combination with a therapy that emphasizes each patient as a separate individual.
authors.affiliation: PAPANASTASIOU: Second Department of Psychiatry, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece KONSTANTINOU: First Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Aiginiteion" University Hospital, Athens, Greece VLACHOS: Department of Psychiatry, 251 Airforce Military Hospital, Athens, Greece.
authors.forename: Artemis
authors.initials: A
authors.lastname: Papanastasiou
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Konstantinou
authors.forename: Themistocles
authors.initials: T
authors.lastname: Vlachos
mesh_terms: D004200:Diseases in Twins; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000235:genetics / Q000503:physiopathology*; D012753:Shared Paranoid Disorder / Q000235:genetics / Q000503:physiopathology*; D014310:Triplets; D014430:Twins, Monozygotic