Folie à deux is a rare psychiatric syndrome in which symptoms of a delusional belief are transmitted from one individual to another. The same syndrome shared by more than two people may be called folie à trois, folie à quatre, folie en famille or even folie à plusieurs ("madness of many"). Recent psychiatric classifications refer to the syndrome as dependency psychotic disorder or induced delusional disorder, although the research literature largely uses the original name. The disorder was first conceptualized in 19th century French psychiatry. In keeping with the record's socially aware nature, the band felt that the term was relevant to the candidates in the 2008 U.S. presidential election. Stump further clarified the title's meaning: "The irony is that people will probably mistake the title as something about romantic relationships in some way. And it's our only record where that theme is not touched upon."
The album received generally positive reviews from music critics. AtMetacritic, which assigns a normalized rating out of 100 to reviews from mainstream critics, the album received an average score of 73, based on 21 reviews, which indicates "generally favorable reviews". Dan Martin of NME gave the record a very positive review, calling a "defining statement" with the band's "most stylistically hatstand-but-indisputably-best songs yet." He wrote, "We're not saying it's as good as genre watermarks American Idiot or The Black Parade. We're just saying it comes close," closing with calling it a "staggering achievement." Stephen Thomas Erlewine of Allmusic rated the album four out of five stars and compared it to labelmate Panic! at the Disco's effort earlier in the year, Pretty. Odd. He wrote that "Fall Out Boy capture the Zeitgeist of the latter half of the 2000s better than any band: there's so much going on in Folie à Deux, you either choose to take it all seriously or take none of it. Fall Out Boy make as much sense when heard either way." Scott Heisel wrote for Alternative Press, commending the band for its "creativity, ingenuity and willingness to try just about anything." He compared the meaning of the term folie à deux ("a madness shared by two") to the two very distinct feelings expressed in the different sides of the record, calling the album a good representation of the band's career.
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