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Fregoli Delusion: The Flip Side of Capgras Syndrome

Fregoli Delusion may include having auditory and visual hallucinations as its symptoms/ Photo By Ion Chiosea via 123RF

 

Fregoli Delusion, according to Fact Republic, refers to a mental disorder wherein the individual “holds a delusional belief that various people [they] meet are in fact a single person in disguise.”  It is categorized as one of the delusional misidentification syndromes (DMs), which means it is a type of psychological disorder that makes a person have delusions about others they socialize with.

Those who are affected by this mental health condition believe that different individuals are actually just one person using different “masks”. Its name was derived from the famous Italian actor Leopoldo Fregoli, who was known in the 19th and 20th century for impersonating political figures and for being able to make sudden transformations in his appearance while performing onstage. Among his well-known impersonations were Victor Hugo, Gladstone, and Bismarck.

In 1927, a 27-year-old woman who firmly believed that her favorite actors were posing as her friends. She described to the two psychiatrists who first studied the condition that she felt that the two actors, Sarah Bernhardt and Robine, whom she often saw at the theater, were harassing her. She told them that they kept chasing her, under the guise of the people she was familiar with which included old employers, strangers she saw on the street, friends, and doctors. She also said they were trying to control her thoughts, which hindered her from doing her usual daily activities. She was also under the delusion that they were forcing her to touch herself. Finally, no longer able to stand their persecution, she retaliated. When she saw a stranger whom she was certain was just Robine in disguise, she beat them. Even if others would attempt to talk her out of thinking they were not Robine, she simply could not be persuaded. After this report, only 40 other patients have been diagnosed with Fregoli Delusion, Telegraph states. This is tantamount to 0.2% of psychiatric patients and 0.5% of individuals who are affected by dementia.

Fregoli Delusion is the opposite of the disorder Capgras Syndrome, which causes an individual to believe that the person they know is not themselves, but an impostor pretending to be them. In other words, they think that an impostor had taken the place of their loved one.

Causes

Lybrate says that Fregoli Delusion stems from impaired parts of the brain. This may be a result of having the parietal and temporal regions of the brain being severely damaged. This may also include having injuries on other neural pathways.

People who are affected by Schizophrenia may also have similar symptoms because they are often paranoid. It is possible that an individual who is going through psychosis may be deluded into thinking that a person they know is just disguising as different people so that they can harm them in some manner.

What Are the Symptoms?

Stephane Thibierge, a psychologist from Universite Paris-Diderot, explains that Fregoli Delusion is a demonstration of how distinguished the procedures of recognition and identification are. She says that people who suffer from this condition have the capacity to tell that individuals have different appearances, but do not have the capability of differentiating their identities.

The symptoms that a patient who is affected by Fregoli Delusion may include having auditory and visual hallucinations, delusions, having a defective visual memory, poor motor functions, and cognitive malfunction.

These symptoms may induce anxiety in them. Individuals with this disorder assume that there is a person who uses elaborate persuasive disguises for the whole day in order to stalk them or hurt them in some way. They are often paranoid about the people whom they consider as impostors. They tend to think that a group of people are just a single individual and that those people are out there to torment them. They also feel disconnected from reality and may not correctly remember places, objects, and events.

Dr. Karel de Pauw, a psychiatrist who has experienced handling a 10-year-old child who suffered from Fregoli Delusion, states that it is hard to convince them that their delusions are not real. She elaborates, “These patients think the person has assumed various cunning disguises and are impossible to reason with.” She then illustrates this by describing how her patient thought her father was shapeshifting into different people. De Pauw continues, “If you say ‘But that nurse is a woman, she can’t be your father,’ they say--’Ah, but you don’t know how clever my father is, you don’t know him as I do, so you can’t pick up the clues.’’

 
Fregoli Delusion is a demonstration of how distinguished the procedures of recognition and identification / Photo By primagefactory via 123RF

 

How Can It Be Treated?

Glenmillermd recommends Cognitive Behavioral Therapy to individuals who are affected by Fregoli Delusion. They may also combine this method of treatment with medication. Some medicines that may help them recover are sedatives, tranquilizers, anticonvulsants, and antipsychotics.  

If the person who suffers from Fregoli Delusion is also found to have other psychological disorders, the doctor may prescribe trifluoperazine, a drug that can address some particular mood or mental disorders such as schizophrenia and psychotic disorders. This medicine aids in reducing the patient’s anxiety, lessening their stress and enhances their cognitive function.

Family members of the patient are also advised to participate in counseling so that they may not feel offended by the patient’s actions.

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