Delusional misidentification syndrome

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Delusional misidentification syndrome
Specialty Psychiatry
Types

Delusional misidentification syndrome is an umbrella term, introduced by Christodoulou (in his book The Delusional Misidentification Syndromes, Karger, Basel, 1986) for a group of four delusional disorders that occur in the context of mental and neurological illness. They are grouped together as they often occur simultaneously or interchange, and they display the common concept of the double (sosie). [1] They all involve a belief that the identity of a person, object, or place has somehow changed or has been altered. Christodoulu further categorized these disorders into those including hypo (or under)-identification of a well-known person (Capgras delusion), and hyper (or over)-identification of an unknown person (the remaining three). [2] As these delusions typically only concern one particular topic, they also fall under the category called monothematic delusions. [3]

Contents

Variants

This psychopathological syndrome is usually considered to include four main variants: [4] [2]

However, similar delusional beliefs, often singularly or more rarely reported, are sometimes also considered to be part of the delusional misidentification syndrome. For example:

There is considerable evidence that disorders such as the Capgras or Fregoli syndromes are associated with disorders of face perception and recognition. However, it has been suggested that all misidentification problems exist on a continuum of anomalies of familiarity, [13] from déjà vu at one end to the formation of delusional beliefs at the other.

See also

Related Research Articles

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Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself. Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame.

A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:

<span class="mw-page-title-main">Jules Cotard</span>

Jules Cotard was a French physician who practiced neurology and psychiatry. He is best known for first describing the Cotard delusion, a patient's delusional belief that they are dead, do not exist or do not have bodily organs.

Capgras delusion or Capgras syndrome is a psychiatric disorder in which a person holds a delusion that a friend, spouse, parent, another close family member, or pet has been replaced by an identical impostor. It is named after Joseph Capgras (1873–1950), the French psychiatrist who first described the disorder.

The Fregoli delusion is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. The syndrome may be related to a brain lesion and is often of a paranoid nature, with the delusional person believing themselves persecuted by the person they believe is in disguise.

Clinical lycanthropy is a rare psychiatric syndrome that involves a delusion that the affected person can transform into, has transformed into, or is, a non-human animal. Its name is associated with the mythical condition of lycanthropy, a supernatural affliction in which humans are said to physically shapeshift into wolves.

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Intermetamorphosis is a delusional misidentification syndrome, related to agnosia. The main symptoms consist of patients believing that they can see others change into someone else in both external appearance and internal personality. The disorder is usually comorbid with neurological disorders or mental disorders. The disorder was first described in 1932 by Paul Courbon (1879–1958), a French psychiatrist. Intermetamorphosis is rare, although issues with diagnostics and comorbidity may lead to under-reporting.

The syndrome of subjective doubles is a rare delusional misidentification syndrome in which a person experiences the delusion that they have a double or Doppelgänger with the same appearance, but usually with different character traits, that is leading a life of its own. The syndrome is also called the syndrome of doubles of the self, delusion of subjective doubles, or simply subjective doubles. Sometimes, the patient is under the impression that there is more than one double. A double may be projected onto any person, from a stranger to a family member.

Reduplicative paramnesia is the delusional belief that a place or location has been duplicated, existing in two or more places simultaneously, or that it has been 'relocated' to another site. It is one of the delusional misidentification syndromes; although rare, it is most commonly associated with acquired brain injury, particularly simultaneous damage to the right cerebral hemisphere and to both frontal lobes.

Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is another person – typically a younger or second version of one's self, a stranger, or a relative. This delusion occurs most frequently in patients with dementia and an affected patient maintains the ability to recognize others' reflections in the mirror. It is caused by right hemisphere cranial dysfunction that results from traumatic brain injury, stroke, or general neurological illness. It is an example of a monothematic delusion, a condition in which all abnormal beliefs have one common theme, as opposed to a polythematic delusion, in which a variety of unrelated delusional beliefs exist. This delusion is also classified as one of the delusional misidentification syndromes (DMS). A patient with a DMS condition consistently misidentifies places, objects, persons, or events. DMS patients are not aware of their psychological condition, are resistant to correction and their conditions are associated with brain disease – particularly right hemisphere brain damage and dysfunction.

A monothematic delusion is a delusional state that concerns only one particular topic. This is contrasted by what is sometimes called multi-thematic or polythematic delusions where the person has a range of delusions. These disorders can occur within the context of schizophrenia or dementia or they can occur without any other signs of mental illness. When these disorders are found outside the context of mental illness, they are often caused by organic dysfunction as a result of traumatic brain injury, stroke, or neurological illness.

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The obsessive–compulsive spectrum is a model of medical classification where various psychiatric, neurological and/or medical conditions are described as existing on a spectrum of conditions related to obsessive–compulsive disorder (OCD). "The disorders are thought to lie on a spectrum from impulsive to compulsive where impulsivity is said to persist due to deficits in the ability to inhibit repetitive behavior with known negative consequences, while compulsivity persists as a consequence of deficits in recognizing completion of tasks." OCD is a mental disorder characterized by obsessions and/or compulsions. An obsession is defined as "a recurring thought, image, or urge that the individual cannot control". Compulsion can be described as a "ritualistic behavior that the person feels compelled to perform". The model suggests that many conditions overlap with OCD in symptomatic profile, demographics, family history, neurobiology, comorbidity, clinical course and response to various pharmacotherapies. Conditions described as being on the spectrum are sometimes referred to as obsessive–compulsive spectrum disorders.

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<span class="mw-page-title-main">Grandiose delusions</span> Subtype of delusion

Grandiose delusions (GD), also known as delusions of grandeur or expansive delusions, and also informally known in Japan as eighth-grade syndrome or chūnibyō, are a subtype of delusion that occur in patients with a wide range of psychiatric disorders, including two-thirds of patients in a manic state of bipolar disorder, half of those with schizophrenia, patients with the grandiose subtype of delusional disorder, frequently as a comorbid condition in narcissistic personality disorder, and a substantial portion of those with substance abuse disorders. GDs are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a religious, science fictional, or supernatural theme. There is a relative lack of research into GD, in contrast to persecutory delusions and auditory hallucinations. Around 10% of healthy people experience grandiose thoughts at some point in their lives but do not meet full criteria for a diagnosis of GD.

Folie à deux, also known as shared psychosis or shared delusional disorder (SDD), is a rare psychiatric syndrome in which symptoms of a delusional belief, and sometimes hallucinations, are "transmitted" from one individual to another.

<span class="mw-page-title-main">Cotard's syndrome</span> Delusion that one is dead or non-existent

Cotard's syndrome, also known as Cotard's delusion or walking corpse syndrome, is a rare mental disorder in which the affected person holds the delusional belief that they are dead, do not exist, are putrefying, or have lost their blood or internal organs. Statistical analysis of a hundred-patient cohort indicated that denial of self-existence is present in 45% of the cases of Cotard's syndrome; the other 55% of the patients presented with delusions of immortality.

The relationship between religion and schizophrenia is of particular interest to psychiatrists because of the similarities between religious experiences and psychotic episodes; religious experiences often involve auditory and/or visual phenomena, and those with schizophrenia commonly report hallucinations and delusions that may resemble the events found within a religious experience. In general, religion has been found to have "both a protective and a risk increasing effect" for schizophrenia.

References

  1. ↑ Christodoulou, George N.; Margariti, Maria; Kontaxakis, Vassilis P.; Christodoulou, Nikos G. (2009). "The delusional misidentification syndromes: strange, fascinating, and instructive". Current Psychiatry Reports. 11 (3): 185–189. doi:10.1007/s11920-009-0029-6. ISSN   1535-1645. PMID   19470279. S2CID   7255596.
  2. 1 2 Bate, Sarah (2017-09-09). Face Recognition and its Disorders. Bloomsbury Publishing. p. 71. ISBN   978-1-137-29277-3.
  3. ↑ Blom, Jan Dirk (2009-12-08). A Dictionary of Hallucinations. Springer Science & Business Media. p. 332. ISBN   978-1-4419-1223-7.
  4. ↑ Ellis HD, Luauté JP, Retterstøl N (1994). "Delusional misidentification syndromes". Psychopathology. 27 (3–5): 117–20. doi:10.1159/000284856. PMID   7846223.
  5. ↑ Christodoulou G.N. Delusional Misidentification Syndromes, Karger, Basel, 1986
  6. ↑ Christodoulou G.N. The Syndrome of Capgras, Br. J. Psychiatry 130, 556, 1977
  7. ↑ Christodoulou G.N. Syndrome of Subjective Doubles, Am. J. Psychiat.135,249,1978
  8. ↑ Benson DF, Gardner H, Meadows JC (February 1976). "Reduplicative paramnesia". Neurology. 26 (2): 147–51. doi:10.1212/wnl.26.2.147. PMID   943070. S2CID   41547561.
  9. ↑ Berrios G.E.; Luque R. (1995). "Cotard Syndrome: clinical analysis of 100 cases". Acta Psychiatrica Scandinavica. 91 (3): 185–188. doi:10.1111/j.1600-0447.1995.tb09764.x. PMID   7625193. S2CID   8764432.
  10. ↑ Shanks MF, Venneri A (November 2002). "The emergence of delusional companions in Alzheimer's disease: an unusual misidentification syndrome". Cogn Neuropsychiatry. 7 (4): 317–28. doi:10.1080/13546800244000021. PMID   16571545. S2CID   25141272.
  11. ↑ Vörös V, Tényi T, Simon M, Trixler M (2003). "'Clonal pluralization of the self': a new form of delusional misidentification syndrome". Psychopathology. 36 (1): 46–8. doi:10.1159/000069656. PMID   12679592. S2CID   29275304.
  12. ↑ Guessoum, Sélim Benjamin; Benoit, Laelia; Minassian, Sevan; Mallet, Jasmina; Moro, Marie Rose (2021). "Clinical Lycanthropy, Neurobiology, Culture: A Systematic Review". Frontiers in Psychiatry. 12: 718101. doi: 10.3389/fpsyt.2021.718101 . ISSN   1664-0640. PMC   8542696 . PMID   34707519.
  13. ↑ Sno HN (1994). "A continuum of misidentification symptoms". Psychopathology. 27 (3–5): 144–7. doi:10.1159/000284861. PMID   7846229.
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