Delusional Misidentification Syndrome
What is Delusional Misidentification Syndrome?
Delusional misidentification syndrome (DMS) is an umbrella term for a collection of delusions that involve misidentifying a person, object, place, body part, or the delusional person themselves.
Delusional Misidentification Syndromes are associated with neurological trauma, dissociation, and schizophrenic disorders.
Types of Delusional Misidentification Syndromes
Delusional Misidentification Syndromes typically involve misidentifying one of three things: the self, the other, and/or the place.
The self: These delusions involve the misidentification of the person themselves, or a part of their body.
The other: These delusions involve the misidentification of other people, pets, or objects.
The place: These delusions involve the misidentification of places or locations.
The Self
Mirrored self misidentification is the delusion that the person’s reflection is someone else.
Syndrome of subjective doubles is the delusion that the person has a double (doppelgänger / clone) of themselves acting independently.
Cotard(’s) delusion / syndrome is the delusion that the person, or parts of their body or organs, are dead, dying, or don’t exist. Most people with this delusion have severe depression.
Clinical zoanthropy is the delusion that the person has turned, or is turning, into an animal. It can be considered a type of reverse intermetamorphosis.
The Place
Reduplicative paramnesia is the belief that a place or location (or, rarely, an object, person, or part of the body) as having been copied, existing in two places at the same time, or moved to a different location. Most case studies involve people reporting the hospital they are in is in their home town, when it isn’t. “Paramnesia” is commonly called déjà vu.
The Other
Capgras delusion is the delusion that someone close to the person, such as a friend, family member, or a pet, has been replaced with an identical imposter.
Frégoli delusion is the delusion that other people are actually the same person in disguise. Capgras and Fregoli delusions often co-exist.
Intermetamorphosis is the delusion that other people can change their appearance and personality at will, pretending to be the person they are basing themselves off.
Delusional companion syndrome is the delusion that objects (often stuffed toys) are sentient, and have their own sense of self, wants and needs.
Other features of Delusional Misidentification Syndromes
Delusional Misidentification Syndromes often have the following features:
- Misidentification occurs with things or beings significant to the person (e.g. their siblings)
- The misidentification is consistent (e.g., the misidentification is of a particular person, not of any random person)
- There is a lack of awareness
- There is denial of any problems associated with the Delusional Misidentification Syndrome
- Many people with Delusional Misidentification Syndrome have right frontal hemisphere dysfunction in their brain
Since Delusional Misidentification Syndromes involve psychosis, it can be part of psychotic disorders, but Delusional Misidentification Syndromes are most often associated with neurological disorders, developmental disorders, and traumatic brain injuries. Delusional Misidentification Syndromes are also associated with dissociation, paranoia, and depression, particularly in Cotard’s.
What can be done for a person with Delusional Misidentification Syndrome?
Option 1: Nothing. Psychotic people can live happy lives without any intervention!
Option 2: Therapy. This can include either accepting the delusion / going along with it, or trying to change it. It can be used in combination with pharmacotherapy (medication).
Option 3: Pharmacotherapy. Antipsychotics and other medication can help reduce symptoms. It can be used in combination with talk therapy.
No matter what choice the person makes (and it should be up to the person), the desired outcome is reducing suffering (which might not mean trying to stop or slow the psychosis) and increasing their quality of life.