Fregoli Syndrome -- A Review Article

 

Mrs Sunitha P. S, Mrs. Rashmi P, Mrs. Vidya, Mrs. Purohit Saraswati

J.S.S College of Nursing, Ramanuja Road. Mysuru-570004

*Corresponding Author E-mail: sunithaygowda555@gmail.com

 

ABSTRACT:

Fregoli delusion or the delusion of doubles is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. The syndrome may be related to a brain lesion and is often of a paranoid nature with the delusional person believing themselves persecuted by the person they believe is in disguise. Fregoli caused by Levodopa treatment and traumatic brain injury and exibit the signs and symptoms Delusions, Visual memory deficit, deficit in self-monitoring, deficit in self-awareness, Hallucinations and treatment and mostly utilize the antipsychotic type of drugs as well as antidepressant medication.

 

KEYWORDS: Fregoli, delusion, Levodopa, Traumatic brain injury, Hallucinations.

 

 


INTRODUCTION:

A person with the Fregoli delusion can also inaccurately replicate places, objects, and events.

 

This disorder can be explained by "associative nodes." The associative nodes serve as a biological link of information about other people with a particular familiar face (to the patient) This means that for any face that is similar to a recognizable face to the patient, the patient will recall that face as the person they know.

 

Definition:

Fregoli delusion or the delusion of doubles is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.

 

The syndrome may be related to a brain lesion and is often of a paranoid nature with the delusional person believing themselves persecuted by the person they believe is in disguise.

 

History:

Fregoli syndrome was discovered in 1927 in a woman who thought her favorite actresses were disguising themselves as her friends, her employers and even strangers. The doctors named the condition after Italian entertainer Leopold Fregoli who did excellent impersonations of contemporary political figures. Less than 50 cases of the disorder have been reported worldwide since then. We report the case of a patient with schizophrenia who developed Frégoli syndrome within the context of using social networking Web sites.1

 

Causes:

Levodopa treatment Levodopa, also known as L-DOPA, is the precursor to several catecholamines specifically of dopamine, epinephrine and norepinephrine. It is clinically used to treat Parkinson's disease and dopamine-responsive dystonia. Clinical studies have shown that the use of levodopa can lead to visual hallucinations and delusions. In most patients, delusions were more salient than hallucinations. With prolonged use of levodopa, the delusions occupy almost all of a patient's attention. In experimental studies, when the concentration of levodopa decreases, the number of reported delusions decreases as well. It has been concluded that delusions related to antiparkins medications are one of the leading causes of Fregoli syndrome.

 

Traumatic brain injury:

Injury to the right frontal and left temporo-parietal areas can cause Fregoli syndrome. Research by Feinberg et al. Has shown that significant deficits in executive and memory functions follow shortly after damage in the right frontal or left temporo-parietal areas. Tests performed on patients that have suffered from a brain injury revealed that basic attention ability and visuomotor processing speed are typically normal. However, these patients made many errors when they were called to participate in detailed attention tasks. Selective attention tests involving auditory targets were also performed, and brain-injured patients had many errors; this meant that they were deficient in their response regulation and inhibition.2

 

Signs and symptoms:

Signs and symptoms of Fregoli's:

·        Delusions

·        Visual memory deficit

·        Deficit in self-monitoring

·        Deficit in self-awareness

·        Hallucinations

·        Deficit in executive functions

·        Deficit in cognitive flexibility

·        History of seizure activity epileptogenic activity

 

Difference between the frogoli syndrome and capgras syndrome:

Fregoli syndrome and Capgras syndrome are psychological disorders which cause the patients to develop delusions regarding the people around him and his social interaction. They are called delusional misidentification syndromes (DMs). Both conditions are extremely rare and are believed to develop in patients who already have other psychiatric disorders.

 

Causes:

Fregoli delusions can be caused by severe injury to the temporal and parietal areas of the brain or other neural pathways.

 

Capgras syndrome has more complicated neuroanatomical causes. It is often seen in patients of Alzheimer’s disease and dementia and sometimes in patients of bipolar disorder and paranoia.

Symptoms:

The symptoms of Fregoli syndrome are delusions, visual and auditory hallucinations, cognitive defects, problems in visual memory and motor functioning.
Capgras syndrome is characterized by delusions, lack of emotional response to a familiar face, constant anxiety and depression.

Treatment:

Antipsychotic medication is generally used to treat Fregoli delusions. Anti-seizure drugs and anti-depressants are prescribed to combat other symptoms of the disorder. The family members of the patient are also counselled so that they do not feel insulted by the patient's behavior.

 

Individualized cognitive therapy is much more beneficial in case of Capgras syndrome than medication. Habilitation therapy is a form of treatment where the patient is not repeatedly contradicted and corrected.

 

TREATMENT:

Treatments do exist for Fregoli disorder, and mostly utilize the antipsychotic type of drugs as well as antidepressant medication. At one time, tricyclic antidepressants were used, though following the discovery of their negative side effects treatment more often involves trifluperazine and modern antidepressants such as venlafaxine and fluoxetine. In addition to these, an anticonvulsant medication is sometimes prescribed.4

 

RESEARCH ARTICLE:

Fregoli syndrome is the delusional belief that one or more familiar persons, usually persecutors following the patient, repeatedly change their appearance. This syndrome has often been discussed as a variant of the Capgras syndrome in the literature, but these two syndromes have different phenomenological structures and age and sex distributions. The author presents a review of 34 cases of Fregoli syndrome in the English and French language literature, discussing the syndrome's definition a etiology and course. It is suggested that although an organic substrate may be found in some cases, it is the dominant psychotic theme which determines the content of the syndrome.3

 

SUMMARY:

Fregoli is a delusion disorder delusion of doubles is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. It can caused by levodopa treatment. It is clinically used to treat parkinson's disease and dopamine-responsive dystonia in most patients, delusions were more salient than hallucinations. Signs and symptoms of visual memory deficit, deficit in self-monitoring, deficit in self-awareness treatments do exist for fregoli disorder, and mostly utilize the antipsychotic type of drugs as well as antidepressant medication.

 

REFERENCES:

1.     https://en.wikipedia.org/wiki/Fregoli_delusion

2.     https://www.pharmatutor.org/articles/fregoli-syndrome by J Patnaik

3.     Journals.sage pub.com/doi/pdf/10.3109/0004867940907587 by R Mojtabai

4.     https://www.lybrate.com › Anxiety and Depression › Health Feed › Tips

 

 

 

Received on 11.04.2018        Modified on 11.06.2018

Accepted on 01.07.2018       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2018; 6(3): 269-278.

DOI: 10.5958/2454-2652.2018.00060.4