Klinik, Vorkommen und neuropsychologische ModelleDelusional MisidentificationsSymptoms and Neuropsychological ModelsM. Rentrop1
, T. Theml1
, H. Förstl1
1Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München, Klinikum Rechts der Isar (Direktor: Prof. Dr. H. Förstl)
Die wahnhaften Missidentifikationen umfassen unter anderem das Capgras-, das Frégoli-Symptom und das Symptom subjektiver Doppelgänger. Gemeinsam ist diesen Störungen, dass betroffene Patienten die Identität der eigenen Person oder Angehöriger negieren und von einer psychischen oder physischen Verwandlung überzeugt sind. Neben somatischen Erkrankungen kommen diese unspezifischen psychopathologischen Symptome bei einer Reihe psychischer Erkrankungen vor, am häufigsten im Rahmen schizophrener Psychosen und Demenzen. Neuropsychologischen Erklärungsmodellen zufolge treten Missidentifikationsphänomene auf, wenn infolge einer Schädigung des temporo-limbischen Systems die affektive Identifikation einer wahrgenommenen Person gestört und zugleich die Fähigkeit zur Realitätsprüfung beeinträchtigt ist. Dies stimmt gut mit organischen Befunden überein, die rechtshemisphärische, temporo-limbische Defekte nahe legen. Die besondere Relevanz der Störung scheint in einer erhöhten Gefährdung der Patienten für aggressive Handlungen zu liegen.
Abstract
Delusional misidentifications include the Capgras delusion, Fregoli delusion, the delusion of subjective doubles and other less frequent symptoms. A common denominator of these unspecific psychopathological symptoms is the patients' denial of their identity or the convinction that their identity or the identity of relatives has been altered. These delusional symptoms occur in the context of somatic and mental diseases, most frequently in schizophrenia and dementia. According to neuropsychological and neuroanatomical studies delusional misidentifications are facilitated by lesions of the temporo-limbic system leading to an impairment in the affective recognition and reality control. Patients suffering from delusional misidentifications have a higher risk of aggressive behaviour which emphasises their clinical relevance.
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