Delusional Misidentification Syndromes (DMS) are a group of rare, complex psychiatric conditions characterized by persistent and irrational misidentification of people, places, or even oneself. These syndromes typically arise in the context of neurodegenerative diseases (like Alzheimer’s), schizophrenia, traumatic brain injuries, or stroke, and they reflect a breakdown in the brain's ability to integrate recognition with emotional familiarity.
Capgras Delusion is one of the most well-known types, where an individual believes a familiar person, often a spouse or relative, has been replaced by an identical impostor. Functional MRI studies show this may result from a disconnection between facial recognition areas and emotional processing centers in the brain.
Fregoli Delusion, named after a quick-change Italian actor, involves the belief that multiple people are in fact a single person changing appearances. It is often linked to paranoid schizophrenia and can be triggered by right frontal lobe lesions.
Intermetamorphosis involves the belief that people have exchanged identities with each other, including their personality and physical traits.
Syndrome of Subjective Doubles features the delusion that one has a doppelgänger living a separate, sometimes threatening life.
Reduplicative Paramnesia leads individuals to believe a familiar place exists in duplicate or has been relocated. This condition is frequently associated with right hemisphere brain damage.
Mirrored-Self Misidentification occurs when a person believes their reflection is a different individual, often seen in dementia.
Delusional Companions involve the attribution of life-like qualities to inanimate objects like toys or robots.
Clonal Pluralization of the Self is a rare condition in which a person believes in the existence of multiple, identical versions of themselves.
Treatment typically involves antipsychotic medication, cognitive-behavioral therapy, and addressing any underlying neurological conditions. Early intervention improves outcomes.Delusional Misidentification Syndromes: An Overview of Rare Psychiatric Disorders
