Folie a Deux in 2 Elderly Sisters - Challenges in Diagnosis and Management

Introduction Folie a deux is rare psychiatric disorder where an identical or similar mental affects two more individuals usually with close emotional ties. Management of patients folie may require multiple types treatment including separation, family therapy and antipsychotics. Objectives Narrative case in 2 elderly sisters Methods Clinical presentation through retrospective review clinical notes Results We present living together 76 74 years age. The elder sister, Sister A, presented to Singapore’s Institute Mental Health on October 2021 after she was referred from court for disturbed behaviour than 10 history paranoid delusions against their neighbours, eventually extending strangers general. She admitted stayed hospital February 2022. community services perform home visits due her unwillingness attend subsequent follow ups discharge. During these visits, it determined that B, displaying delusional thinking as well. A started antipsychotics while B managed non-pharmacologically. After commencement antipsychotics, showed good response improvement symptoms, continued display thinking. Discussion made the next-of-kin both sisters, nephew, decision continue observe symptoms monitor resolution A. multidisciplinary approach also used attempt reintegrate them into society rebuild trust public. Currently still report vague paranoia general team involved improving further. Conclusions With this report, we hope raise awareness different methods are useful management along challenges faced when managing cases. Disclosure Interest None Declared