Download PDF
Fortschr Neurol Psychiatr 2002; 70(6): 313-320
DOI: 10.1055/s-2002-32026
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Wahnhafte Missidentifikationen

Klinik, Vorkommen und neuropsychologische ModelleDelusional Misidentifications Symptoms and Neuropsychological Models M.  Rentrop1 , T.  Theml1 , H.  Förstl1
  • 1Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München, Klinikum Rechts der Isar (Direktor: Prof. Dr. H. Förstl)
Further Information

Publication History

Publication Date:
04 June 2002 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

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.

Literatur

  • 1 Jaspers K. Allgemeine Psychopathologie. 9. unveränderte Auflage. Berlin, Heidelberg, New York: Springer 1973
    Search in Google Scholar
  • 2 Ellis H D, Luanté J-P, Retterstøl N. Delusional misidentification syndromes.  Psychopathology. 1994;  27 117-120
    PubMedSearch in Google Scholar
  • 3 Förstl H, Besthorn C, Burns A, Geiger-Kabisch C, Levy R, Sattel A. Delusional misidentification in Alzheimer's Disease: a summary of clinical and biological aspects.  Psychopathology. 1994;  27 194-199
    PubMedSearch in Google Scholar
  • 4 de Pauw K W. Delusional misidentification: a plea for an agreed terminology and classification.  Psychopathology. 1994;  27 123-129
    PubMedSearch in Google Scholar
  • 5 Christodoulou G N. The delusional misidentification syndromes.  British Journal of Psychiatry. 1991;  159 (suppl. 14) 65-69
    PubMedSearch in Google Scholar
  • 6 Cutting J. The Right Cerebral Hemisphere and Psychiatric Disorders. Oxford Univerity Press 1990
    Search in Google Scholar
  • 7 Oyebode F, Sargeant R. Delusional misidentification syndromes: a descriptive study.  Psychopathology. 1996;  29 209-214
    PubMedSearch in Google Scholar
  • 8 Silva J A, Leong G B, Weinstock R. Delusions of transformation of the self.  Psychopathology. 1993;  26 181-188
    PubMedSearch in Google Scholar
  • 9 Weinstein E A. The classification of delusional misidentification syndromes.  Psychopathology. 1994;  27 130-135
    PubMedSearch in Google Scholar
  • 10 Marková I S, Berrios G E. Delusional misidentifications: facts and fancies.  Psychopathology. 1994;  27 136-143
    PubMedSearch in Google Scholar
  • 11 Luauté J P, Bidault E. Capgras syndrome: agnosia of identification and delusion of reduplication.  Psychopathology. 1994;  27 186-193
    PubMedSearch in Google Scholar
  • 12 Postel J, Allen D F. Joseph Capgras (1873 - 1950).  Psychopathology. 1994;  27 121-122
    PubMedSearch in Google Scholar
  • 13 Capgras J, Reboul-Lachaux J. L'illusion des ‘sosies’ dans un délire systématisé chronique.  Bull Soc Clin Méd Ment. 1923;  11 6-16
    PubMedSearch in Google Scholar
  • 14 Courbon P, Fail G. Illusion de Frégoli.  Bull Soc Clin Méd Ment. 1927;  15 121-124
    PubMedSearch in Google Scholar
  • 15 Courbon P, Tusque J. Illusions d'intermétamorphose et de la charme.  Ann Médicopsychol. 1932;  90i 401-406
    PubMedSearch in Google Scholar
  • 16 de Pauw K W. Psychodynamic approaches to the Capgras delusion: a critical historical review.  Psychopathology. 1994;  27 154-160
    PubMedSearch in Google Scholar
  • 17 Pick A. Clinical studies III. - On reduplicative paramnesia.  Brain. 1903;  26 260-267
    PubMedSearch in Google Scholar
  • 18 Anderson D N, Wiliams E. The delusion of inanimate doubles.  Psychopathology. 1994;  27 220-225
    PubMedSearch in Google Scholar
  • 19 McEvedy C JB, Hendry J, Barnes T RE. Delusional misidentification: the illusion of Fregoli and a dog.  Psychopathology. 1996;  29 215-217
    PubMedSearch in Google Scholar
  • 20 Signer S F. Self-substitution as a variant of the Capgras syndrome.  Psychopathology. 1994;  27 232-239
    PubMedSearch in Google Scholar
  • 21 Silva J A, Dassori A, Leong G B. The antichrist delusion as a delusional misidentification syndrome of the self.  Canadian Journal of Psychiatry. 1997;  42 90
    PubMedSearch in Google Scholar
  • 22 Silva J A, Leong G B. The relation of Cotard's syndrome to delusional misidentification.  Israel Journal of Psychiatry Related Sciences. 1996;  33 188-193
    PubMedSearch in Google Scholar
  • 23 Young A W, Leafhead K M, Szulecka T K. The Capgras and Cotard delusions.  Psychopathology. 1994;  27 226-231
    PubMedSearch in Google Scholar
  • 24 Förstl H, Beats B. Charles Bonnet's description of Cotard's delusion and reduplicative paramnesia in an elderly patient (1788).  British Journal of Psychiatry. 1992;  160 416-418
    PubMedSearch in Google Scholar
  • 25 Kirov G, Jones P, Lewis S W. Prevalence of delusional misidentification syndromes.  Psychpathology. 1994;  27 148-149
    PubMedSearch in Google Scholar
  • 26 Joseph A B. Observation on the epidemiology of the delusional misidentification syndromes in the Boston metropolitan area: April 1983 - June 1984.  Psychopathology. 1994;  27 150-153
    PubMedSearch in Google Scholar
  • 27 Förstl H, Almeida O P, Owen A M, Burns A, Howard R. Psychiatric, neurological and medical aspects of misidentification syndromes: a review of 260 cases.  Psychological Medicine. 1991;  21 905-910
    PubMedSearch in Google Scholar
  • 28 Silva J A, Leong G B. The “delirium” of delusional misidentification: implications for the classification of delusional misidentification syndromes.  Canadian Journal of Psychiatry. 1997;  42 665
    PubMedSearch in Google Scholar
  • 29 Silva J A, Leong G B, Rhodes L J, Weinstock R. A new variant of „subjective” delusional misidentification associated with aggression.  Journal of Forensic Science. 1997;  42 406-410
    PubMedSearch in Google Scholar
  • 30 de Pauw K W, Szulecka T K. Dangerous delusions. Violence and the misidentification syndromes.  British Journal of Psychiatry. 1988;  152 91-96
    PubMedSearch in Google Scholar
  • 31 Silva J A, Leong G B, Weinstock R, Sharma K K, Klein R L. Delusional misidentification syndromes and dangerousness.  Psychopathology. 1994;  27 215-219
    CrossrefPubMedSearch in Google Scholar
  • 32 Silva J A, Ferrari M M, Leong G B, Weinstock R. The role of mania in the genesis of dangerous delusional misidentification.  Journal of Forensic Science. 1997;  42 670-674
    PubMedSearch in Google Scholar
  • 33 Stompe T, Strobl R. Negative Wahnidentitäten in schizophrenen Psychosen. Kasuistische Untersuchungen zur Phänomenologie und Pathogenese.  Fortschritte Neurol Psychiat. 2000;  68 169-175
    PubMedSearch in Google Scholar
  • 34 Lempa G. Zur psychoanalytischen Theorie der psychotischen Symptombildung. In: Mentzos S (Hrsg.). Psychose und Konflikt Göttingen: Vandenhoeck und Ruprecht 2. Auflage 1995: 29-77
    Search in Google Scholar
  • 35 Arenz D. Psychiatrische Doppelgängerphänomene unter besonderer Berücksichtigung des Capgras-Syndroms.  Fortschritte der Neurologie und Psychiatrie. 2000;  68 516-522
    PubMedSearch in Google Scholar
  • 36 Breen N, Caine D, Coultheart M. Models of face recognition and delusional misidentification: a critical review.  Cognitive Neuropsychology. 2000;  17 55-71
    CrossrefPubMedSearch in Google Scholar
  • 37 Ellis H D, Lewis M B. Capgras delusion: a window on face recognition.  Trends in Cognitive Sciences. 2001;  5 (4) 149-156
    CrossrefPubMedSearch in Google Scholar
  • 38 Ellis H D, Young A W. Accounting for delusional misidentifications.  British Journal of Psychiatry. 1990;  157 239-248
    PubMedSearch in Google Scholar
  • 39 Fleminger S. Delusional misidentification: an exemplary symptom illustrating an interaction between organic brain disease and psychological processes.  Psychopathology. 1994;  27 161-167
    PubMedSearch in Google Scholar
  • 40 Gerrans P. Refining the explanation of Cotard's delusion.  Mind & Language. 2000;  15 (1) 111-122
    PubMedSearch in Google Scholar
  • 41 Langdon R, Coltheart M. The Cognitive Neuropsychology of Delusions.  Mind & Language. 2000;  15 (1) 184-218
    PubMedSearch in Google Scholar
  • 42 Ellis H D, Young A W, Quayle A H, de Pauw K W. Reduced autonomic responses to faces in Capgras delusion.  Proceeding of the Royal Society of London: Biological Sciences. 1997a ;  B265 1085-92
    PubMedSearch in Google Scholar
  • 43 Ellis H D, Young A W, Quayle A H, de Pauw K W. Response from Ellis, Young, Quayle and de Pauw.  Trends in Cognitive Sciences. 1997b;  1 158
    CrossrefPubMedSearch in Google Scholar
  • 44 Hirstein W, Ramachandran V S. Capgras syndrome: a novel probe for understanding the neural representation of the identity and familiarity of persons.  Proceedings of the Royal Society London B Biological Sciences. 1997;  264 437-444
    CrossrefPubMedSearch in Google Scholar
  • 45 Ellis H D, Lewis M B, Moselhy H F, Young A W. Automatic without autonomic responses to familiar faces: differential components of covert recognition in a case of Capgras delusion.  Cognitive Neuropsychiatry. 2000;  5 255-269
    CrossrefPubMedSearch in Google Scholar
  • 46 Bruce V, Young A. Understanding face recognition.  British Journal of Psychology. 1986;  77 305-327
    PubMedSearch in Google Scholar
  • 47 Phillips M L, David A S. Facial processing in schizophrenia and delusional misidentification: cognitive neuropsychiatric approaches.  Schizophrenia Research. 1995;  17 109-114
    CrossrefPubMedSearch in Google Scholar
  • 48 Edelstyn N MJ, Oyebode F. A review of the phenomenology and cognitive neuropsychological origins of the Capgras syndrome.  International Journal of Geriatric Psychiatry. 1999;  14 48-59
    PubMedSearch in Google Scholar
  • 49 Feinberg T E, Roane D M. Anosognosia, completion and confabulation: The neutral personal dichotomy.  Neurocase. 1997;  3 73-85
    CrossrefPubMedSearch in Google Scholar
  • 50 Feinberg T E, Shapiro R M. Misidentification-reduplication and the right hemisphere.  Neuropsychiatry, Neuropsychology and Behavioral Neurology. 1989;  2 39-48
    PubMedSearch in Google Scholar
  • 51 Sno H N. A continuum of misidentification symptoms.  Psychopathology. 1994;  27 144-147
    PubMedSearch in Google Scholar
  • 52 Bauer R. Autonomic recognition of names and faces: A neuropsychological application of the Guilty Knowledge Test.  Neuropsychologia. 1984;  22 457-469
    CrossrefPubMedSearch in Google Scholar
  • 53 Milner A D, Goodale M A. The visual brain in action. Oxford University Press 1995
    Search in Google Scholar
  • 54 Shah N J, Marshall J C, Zafiris O, Schwab A, Zilles K, Markowitsch H J, Fink G R. The neural correlates of person familiarity. A functional magnetic resonance imaging study with clinical implications.  Brain. 2001;  124 804-815
    CrossrefPubMedSearch in Google Scholar
  • 55 Nakamura K, Kawashima R, Sato N, Nakamura A, Sugiura M, Kato T, Hatano K, Ito F, Fukuda H, Schormann T, Zilles K. Functional delination of the human occipito-temporal areas related to face and scene processing. A PET-study.  Brain. 2000;  123 1903-1912
    CrossrefPubMedSearch in Google Scholar
  • 56 Hudson A J, Grace G M. Misidentification syndromes related to face specific area in the fusiform gyrus. Neurol.  Neurosurg Psychiatry. 2000;  69 645-648
    PubMedSearch in Google Scholar
  • 57 Ellis H D. The role of the right hemisphere in the Capgras delusion.  Psychopathology. 1994;  27 177-185
    PubMedSearch in Google Scholar
  • 58 Cutting J. Delusional misidentification and the role of the right hemisphere in the appreciation of identity.  British Journal of Psychiatry. 1991;  159 (suppl. 14) 70-75
    PubMedSearch in Google Scholar
  • 59 Hartje W. Funktionelle Asymmetrie der Großhirnhemisphären. In: Hartje W, Poeck K. Klinische Neuropsychologie. 3. neubearbeitete Auflage Thieme-Verlag 1997: 36-58
    Search in Google Scholar
  • 60 Shraberg D, Weitzel D W. Prosopagnosia and the Capgras syndrome.  Journal of Clinical Psychiatry. 1979;  40 313-316
    PubMedSearch in Google Scholar
  • 61 Feinberg T E, Eaton L A, Roane D M, Giacino J T. Multiple Fregoli delusions after traumatic brain injury.  Cortex. 1999;  35 373-387
    PubMedSearch in Google Scholar
  • 62 Lebert F, Pasquier F, Steinling M, Cabaret M, Caparros-Lefebvre D, Petit H. SPECT data in a case of secondary Capgras delusion.  Psychopathology. 1994;  27 211-214
    PubMedSearch in Google Scholar
  • 63 Paillére-Martinot M L, Dao-Castellana M H, Masure M C, Pillon B, Martinot J L. Delusional misidentification: a clinical, neuropsychological and brain imaging case study.  Psychopathology. 1994;  27 200-210
    PubMedSearch in Google Scholar
  • 64 Wright S, Young A W, Hellawell D J. Sequential Cotard and Capgras delusions.  British Journal of Clinical Psychology. 1993;  32 345-9
    PubMedSearch in Google Scholar
  • 65 Young A W, Robertson I H, Hellawell D J, de Pauw K W, Pentland B. Cotard delusion after brain injury.  Psychological Medicine. 1992;  67 361-70
    PubMedSearch in Google Scholar
  • 66 Ruff R L, Volpe B T. Environmental reduplication associated with right frontal and parietal lobe injury.  Journal of Neurology, Neurosurgery and Psychiatry. 1981;  44 382-386
    PubMedSearch in Google Scholar

Dr. med M. Rentrop

Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München
Klinikum Rechts der Isar

Ismaningerstr. 22

81675 München