Mad House is a 1981 Italian horror film directed by Ovidio Assonitis. Julia (Trish Everly) is a meek and mild young woman who was traumatized her entire life by her evil twin sister, Mary (Allison Biggers). Seven years after Julia leaves her dysfunctional family behind and becomes a teacher for deaf students, she gets a call from Mary. All the bad memories come rushing back. Their uncle, James (Dennis Robertson), wants the two to reconcile since Mary is very ill and suffers from a debilitating illness. Mary is confined in a mental institution and wants to see her sister. Julia finds out that Mary has escaped from the institution and suddenly horrible things begin to happen. Julia's friends and students start dying under mysterious circumstances. It takes all of Julia's inner strength to fight back. As she begins to investigate the murders, it becomes apparent that Mary may not be the killer after all.