DELUSIONAL MISIDENTIFICATION SYNDROME: DISSOCIATION BETWEEN RECOGNITION AND IDENTIFICATION PROCESSES

Abstract

Delusional misidentification syndrome (DMS) is an umbrella term for syndromes of intermetamorphosis, Fregoli, and Capgras. DMS) is thought to be related to dissociation between recognition and identification processes. DMS was described for the first time in 1932 as a variant of the Capgras syndrome and is currently on the DSM-V list of diseases as an independent disease entity. Patients affected by DMS believed that people around them, most often family, have changed physically (appearance) and mentally (character). Other symptoms include confabulation, derealization or depersonalization. In patients, aggressive behavior is often observed, aimed at alleged doppelgangers resulting from the sense of being cheated and manipulated. With the intermetamorphosis syndrome, for example, schizophrenia, depression, bipolar disorder or other misidentification syndromes (Fregoli's, Capgras) may coexist. There is also a reverse intermetamorphosis, where the object of the changed appearance or character becomes the patient himself. One of its forms may be lycanthropy. The etiology of the intermetamorphosis has not been fully understood, one of the reasons may be brain damage and changes in the parietal and/or temporal lobes of the right hemisphere. It may then damage long neuronal connections to the frontal areas of the brain, disturbances of working memory (WM) accountable for the keep and online management of data, so that it is available for further processing, and the patient's will be uncritical. The basic method of diagnosis of this delusion is a medical interview with the patient. Other diagnostic methods include computed tomography, magnetic resonance imaging, EEG and ERPs. Experimental methods include searching for the neuromarker of DMS. Currently, there are no treatment guidelines of this delusional disorder, and pharmacotherapy experimental, but the drugs from the group of neuroleptics and lithium seem effective. Some hope for the treatment is created by neurotherapy, but it is also experimental.