PSY101 NEWS REPORT

Fregoli Syndrome

Submitted by: Angela Abao Miguel Benavides Section E Jan. 6, 2014

WHAT is Fregoli Syndrome?

- When a person holds delusional belief that different people are in fact a single person in disguised - Classed as monothematic delusion and as a delusional misidentification syndrome

Named after an Italian actor, Leopold Fregoli

Symptoms:
- Misidentifying unfamiliar people or places as familiar ones - Visual-spatial perception and memory impairments - Prosopagnosia i.e. facial recognition impairment

- Violent behavior

Causes/ Etiology: Cognitive

- Paranoid schizophrenia
- Seizures - often associated in many cases years after an attack - Epileptogenic activity - Abnormal decision-making or reasoning ability

Causes/ Etiology: Cognitive

- Psychosis with organic etiology (i.e. neurological abnormalities) - cortical atrophy in frontal and temporal areas (i.e. tissue degradation on the outer foldings of the brain) - damage to the occipital-temporal area leading to visual spatial perception and memory impairments - bifrontal/ right hemisphere lesions leading to facial recognition impairment

- hyperfamiliarity - overactivity in right perirhinal cortex

Causes/ Etiology: Psychodynamic

- Ambivalence theory - ambivalent feelings toward the supposed imposter manifest as denial and displacement;
- Depersonalization/derealization theory - affected patients perceive their environment and their bodies in an unusual way that is experienced more strongly with objects or people they have strong affinities for.

- Regression theory - a compromise in higher brain function leads to a return to primitive modes of thinking characterized by themes of doubles and dualisms usually found in myth, primitive religion, and literature.

Comorbidities
- Intermetamorphosis - patients believe they see people change physically and personally

- Affective disorders (i.e. dramatic mood changes)

- Capgras syndrome - Syndrome of subjective doubles - the delusional belief that physical duplicates of the self exist but with their own psychological identities - Erotomania - the delusional belief that one is loved by someone else

Treatment
- A typical Antipsychotics such as olanzapine, sulpiride, quetiapine

- Anticonvulsant and Antidepressants

- Treatment often use trifluperazine if other psychological disorders are present

Case 1: Mr. A (21 yrs. old)

- he believed that his facial cream strongly attracts female students and that it perfects his looks - He spent a lot of time in Facebook, where he met a young woman whom he want to have an intimate relationship with but the woman withdrew - He developed a belief that every time a woman would contact her in Facebook, it was the same woman from before whos just disguising herself.

Case 2: Mr. F (37 yrs. old)

- special case of Fregoli because the copy of the own mind is believed to inhabit the body of others - complained about hearing voices which caused him to feel fearful of others. - When he was arrested, he believed that there are machines in the jail that could copy ones brain, including his own

- He also believed that copies of his brain were place inside people whom he havent met before
- He identifies them through mannerisms that are similar to his

Case 3: 22 yrs old Hungarian

- Met a woman in Hungary and thought that she loved him after talking for a while - Knowing that girls hometown and school, he went to Germany to look for her - Misidentified his neighbour's daughter as the woman he was looking for (Fregoli Syndrome)

- Harassed the family and threatened her father

Case 3: 22 yrs old Hungarian

- Had delusions that the woman is dead and that the body is hidden in the attic (Cotard Syndrome) - In the hospital, he claimed to be someone else having German origins rather than Hungarian

- Didnt recognized his original parents

- Thought that they were replaced by physically identical persons (Capgrass Syndrome)

Bibliography
1. Yalin, ., Varol Ta, F., & Gunevr, T. (2008). The Coexistence of Capgras, Fregoli and Cotard's Syndromes in an Adolescent Case. Archives Of Neuropsychiatry / Noropsikiatri Arsivi, 45(4), 149-151. 2. Silva, J. A., & Leong, G. B. (1991). A case of "subjective" Frgoli syndrome.Journal of Psychiatry and Neuroscience, 16(2), 103 3. Phillips, M. L., & David, A. S. (1995). Facial processing in schizophrenia and delusional misidentification: cognitive neuropsychiatric approaches.Schizophrenia research, 17(1), 109-114. 4. Edelstyn, N. J., Riddoch, M. J., Oyebode, F. F., Humphreys, G. ., & Forde, E. E. (1996). Visual Processing in Patients with Fregoli Syndrome. Cognitive Neuropsychiatry, 1(2), 103-124. doi:10.1080/135468096396587 5. Hintzen, A., Wilhelm-Gling, C., & Garlipp, P. (2008). Combined Delusional Syndromes in a Patient with Schizophrenia: Erotomania, Delusional Misidentification Syndrome, Folie Deux and Nihilistic Delusion.Unverffentlichtes Manuskript.

Bibliography
6. Delavenne, H., & Garcia, F. D. (2011). Fregoli syndrome associated with violent behavior. J Bras Psiquiatr, 60(1), 67-70. 7. Devinsky, O., Davachi, L., Santchi, C., Quinn, B. T., Staresina, B. P., & Thesen, T. (2010). Hyperfamiliarity for faces. Neurology, 74(12), 970-974. 8. Wright, S., Young, A. W., & Hellawell, D. J. (1993). Frgoli delusion and erotomania. Journal of neurology, neurosurgery, and psychiatry, 56(3), 322. 9. Jocic, M. D. (2011). Delusional misidentification syndromes. Jefferson Journal of Psychiatry, 10(1), 4. 10. Physicians Postgraduate Press, Inc. (2012, January 26). A Contemporary Case of Frgoli Syndrome. Retrieved from National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357570/