Fregoli delusion

Fregoli delusion is a rare disorder characterized by the belief that different people are in fact a single person who changes appearance or is in disguise. The condition is named after the Italian actor Leopoldo Fregoli, who was renowned for his ability to make quick changes of appearance during his stage act. Fregoli delusion is classified as a type of delusional misidentification syndrome (DMS), a group of disorders that involve consistent misidentification of people, places, or objects. Unlike Capgras delusion, where the individual believes that a familiar person has been replaced by an impostor, individuals with Fregoli delusion believe that various people are actually a single person who is capable of assuming multiple guises.

Symptoms and Diagnosis

The primary symptom of Fregoli delusion is the belief that different people are the same person in disguise, often accompanied by paranoia and the belief that this person is persecuting them. Diagnosis involves a thorough psychiatric evaluation, as the delusion can be associated with various psychiatric conditions, including schizophrenia, bipolar disorder, and Alzheimer's disease. Neuroimaging studies, such as MRI or CT scans, may also be conducted to rule out neurological conditions that could contribute to delusional symptoms.

Causes

The exact cause of Fregoli delusion is not well understood, but it is believed to involve abnormalities in brain regions responsible for facial recognition and memory, particularly the fusiform gyrus and the amygdala. These abnormalities may disrupt the normal processing of faces and the emotional responses to them, leading to the misidentification seen in Fregoli delusion. Genetic factors, brain injury, and certain neurological conditions may also play a role in the development of the disorder.

Treatment

Treatment for Fregoli delusion typically involves a combination of antipsychotic medication and psychotherapy. Antipsychotic drugs can help reduce delusional beliefs and paranoia, while psychotherapy, particularly cognitive-behavioral therapy (CBT), can help the individual understand and cope with their delusions. In some cases, treatment of the underlying psychiatric or neurological condition may also alleviate the symptoms of Fregoli delusion.

Prognosis

The prognosis for individuals with Fregoli delusion varies depending on the underlying cause of the disorder and the individual's response to treatment. In some cases, symptoms can be effectively managed with medication and therapy, leading to a significant improvement in quality of life. However, in other cases, the delusion may be resistant to treatment, especially if it is part of a broader psychotic disorder.

See Also

• Capgras delusion
• Delusional misidentification syndrome
• Prosopagnosia