Frégoli syndrome: definition, symptoms and causes
The delusions of false identification are a type of delirium that is especially striking since it implies the erroneous recognition of other people, sometimes even of oneself.
In this article we will talk about Symptoms and causes of Frégoli syndrome , one of the most popular false identification delusions.
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What is Frégoli syndrome?
Frégoli syndrome is a delirium consisting of belief that one or several known people are being supplanted by someone who uses a disguise or changes their appearance in another way.
It is often associated with a paranoid component, since people with Frégoli syndrome tend to think that the supplanter pursues them to harm them or at least harm them.
It is a monothematic delirium classified within the category of what we know as "delusions of false identification". It is related to disorders such as psychosis, dementia and brain injuries.
Like other similar delusions, Frégoli syndrome is associated with a deficit in face recognition : the perception of unknown faces would trigger the mistaken identification of these with other more familiar ones, usually loved ones or celebrities. It can also be influenced by other senses, such as hearing and smell.
- Related article: "Prosopagnosia, the inability to recognize human faces"
History of the disorder
The Frégoli syndrome was described by two French psychiatrists, Courbon and Fail , in his 1927 paper Syndrome d'illusion de Frégoli et schizophrénie ("Frégoli Illusion Syndrome and Schizophrenia").
Courbon and Fail explained the case of a 27-year-old domestic servant, a great fan of the theater, who believed that the famous actresses Robine and Sarah Bernhardt disguised themselves as people they knew to negatively influence their thoughts and behavior - for example preventing her from working or forcing her to masturbate.
The name "Frégoli syndrome" refers to the Italian actor Leopoldo Frégoli , who was known for his ability for transformism, imitation and disguise.
Oliver Sacks popularized this delirium through his book "The man who confused his wife with a hat", from 1985. Since then he has inspired several films, such as Total Challenge, Perfect Women or Anomalisa.
Since its description in 1927, only 40 cases have been documented worldwide, although it is believed that this disorder is likely to be underdiagnosed.
Signs and symptoms
People with Frégoli syndrome usually present a series of alterations that predispose to the appearance of symptoms; In particular, deficits in visual memory, self-monitoring, executive functions, cognitive flexibility and self-consciousness have been detected.
This means that they may have more difficulty remembering visual information, to control and monitor their own behavior, to differentiate themselves from others, or to think about several concepts at the same time.
The Frégoli syndrome also is more likely in people with a history of seizures , especially if they have occurred during epileptic seizures.
The fundamental symptoms of this disorder often coexist with hallucinations and other delusions. The delusions are beliefs that are held immovably despite the fact that there are tests that conclusively deny them, while hallucinations consist of the perception of external stimuli that do not exist.
Causes of Frégoli syndrome
Psychosis is one of the most frequent causes of Frégoli syndrome. The delusions are one of the cardinal symptoms of schizophrenia and other similar disorders . In this case we speak in most cases of a persecutory delirium.
In diseases that affect the brain, particularly dementias, it is common for psychotic delusions such as Frégoli to occur as brain involvement progresses.
Another common cause are levodopa treatments , a catecholaminergic drug that is used primarily to treat Parkinson's disease. The longer the treatment and the higher the dose, the more likely it is that hallucinations and especially delusions will develop.
The cerebral traumatisms they can cause the appearance of Frégoli syndrome; In particular, cases have been documented in people with lesions in the frontal lobe, in the temporoparietal region and in the fusiform gyrus , which is involved in visual recognition and contains a specific area for the faces, the ventral fusiform cortex.
Alterations in the selective attention, working memory or cognitive flexibility that characterize many patients of Frégoli are common consequences of brain injuries and predispose to the appearance of this and other delusions.
Other delusions of false identification
Delusions of false identification consist in the erroneous recognition of people, places or other stimuli. Among these we find several disorders very similar to Frégoli syndrome.
The best known of these delusions is the Capgras syndrome or delirium of Sosías , in which it is believed that a loved one has been replaced by an identical double. As it happens in the syndrome of Frégoli, the most frequent is that it is a persecutory delirium in which negative intentions are attributed to the supposed impostor.
In the delirium of intermetamorphosis , also described by Courbon, the patient believes that the people of his environment exchange identity, while maintaining the same appearance.
The syndrome of subjective doubles consists in the belief that one or several doubles have their own personality and body that usurp identity.
- You may be interested: "" Cotard syndrome ": living people who believe they are dead"
Treatment of these syndromes
Cognitive-behavioral treatments for delusions focus on cognitive restructuring through the normalization of symptoms, non-confrontational verbal challenge and reality tests to refute the client's hypothesis.
In cases of psychosis, induced or not by brain diseases, the symptoms may remit with the use of antipsychotic drugs, which fundamentally modify the dopaminergic activity.
Anticonvulsant medications They are effective in combating epilepsy, including the delusional symptoms that can occur in the context of this disease.