Fregoli's syndrome, or Fregoli's delusions, is a mental illness that got its name in honor of the Italian comedian of the late 19th and early 20th centuries, known for his talent for impersonation. People with this pathology are prone to persecution mania. Moreover, they are convinced that they are constantly pursued, and the pursuers themselves are extremely cunning (to the point that they are able to change their appearance beyond recognition). People with Fregoli syndrome may see a threat in an ordinary adult, a small child, an animal, and even inanimate objects (trees, rocks, etc.).
Etiology of disease
There may be several reasons for the appearance of Fregoli's syndrome. Usually, an x-ray of the brain reveals the presence of some organic component, which affects the functioning of the entire nervous system, causing malfunctions. Any visual information first enters the fusiform gyrus, where the distinction between living or non-living objects begins. The processed result through the third path goes to the amygdala, which is responsible for the emotional state. Therefore, if there is damage to some of the fibers, the patient is able to demonstrate positive and negative reactions, but the perception-emotion connection is broken.
Today, a number of psychiatrists tend to consider Fregoli's delusions one of the manifestations of a fantastic disorder, as well as megalomania, persecution and psychological automatism. People with such inclinations think that they are kings, emperors or rulers of the whole world.
At risk are patients suffering from paranoid schizophrenia, epilepsy, dementia, as well as those who have had traumatic brain injury of both open and closed type.
Symptoms
The main symptom of Fregoli's syndrome is that the patient considers strangers to be his acquaintances who follow him. At the same time, the patient is well aware of all the differences in appearance, but ignores those at the psychological level. Fregoli's delusions are often associated with schizophrenia. The patient believes that he is hypersensitive, and therefore can determine who or what a person or object really is, no matter how well he disguises.
Such a patient can talk about his own power, reinforcing this with highly exaggerated or fictional examples. However, delirium is not permanent. A person always comes up with new events, not forgetting about detailing. At the same time, he does notproves, because he is infinitely convinced of his own rightness. Sometimes there are speeches about reading minds or influencing people with the same "power of thought".
Against the background of everything described, a person can suffer from very real pains that can cause serious discomfort.
Thus, the most common manifestations of Fregoli's syndrome are:
- persecution mania;
- hypersensitivity;
- megalomania;
- physical pain.
Features of pathology
The course of the disease is closely associated with pseudohallucinations, confabulation and retrospective delusions. Under the influence of the latter, the patient may re-evaluate his life in connection with the new worldview.
The impact of confabulation is wider, since the events of the past are already intertwined in the mind of the patient with his sick fantasies. This affects the ability to remember in the direction of deterioration. In addition, a person's orientation in space is disturbed. There are also emotional changes. The patient is either elated or manic.
Depression is less common in Fregoli's delusions. For him, acute paraphrenia is more characteristic - vivid hallucinations associated with hypersensitivity and unstable confabulations. Against this background, the delirium is fantastic.
Sometimes a catatonic syndrome is manifested separately - a failure of the motor system, expressed in lethargy or excitation. If the disease becomes chronicstage, the person is under stable delirium, hiding all the time from "enemies" and fearing invasion of his shelter.
Diagnosis of Fregoli syndrome
To make a diagnosis, the psychiatrist determines what type of delusion the patient is predominantly (whether there are fantastic thoughts, delusions of persecution or grandeur, etc.).
A chronic disease can be said if the patient demonstrates a permanent delusional state, hides from "persecution" all the time and checks his home for "invasion".
Treatment of Fregoli syndrome
For the patient, the emotional background that family members create is extremely important. It is not necessary to explain to such a patient, especially in the acute stage, that he is wrong and that nothing threatens him. This will only make the situation worse. Help and support would be right. It is worth going around the house with him, jointly making sure that there is no "danger".
If pathological perception is of a single nature, then we can talk about the development of schizophrenia. Moreover, the manifestation of the symptom of a double speaks of a paraphrenic form. However, the treatment regimen remains the same for both cases.
Therapy for Fregoli's delusions can take several years. The prognosis of the disease depends on many factors. Of great importance is the duration of the patient's stay without qualified assistance. The presence of other mental illnesses also affects the prognosis.
Examples of recorded cases
First time aboutthis disease was written in 1927 by P. Courbon and J. Feil. Their article talked about a young woman who frequented the theatre. She believed that she was constantly pursued by actors who dressed up as her acquaintances.
One of the patients suffering from persecution mania was convinced that when he visited certain places, a person constantly followed him, taking the form of a passerby, a schoolboy and even a sparrow. At the same time, another feature characteristic of the Fregoli syndrome was manifested - antagonism. This patient saw in others not only "enemies", but also "his own". Each group had a clear role to play. "Enemies" tirelessly persecute, and "ours" provide support. For example, if the "pursuer" gets too close, "friend" will force him to leave.
Patients with Fregoli's delusion often demonstrate psychic automatism in fantastic content. Many can mentally talk to famous people or non-existent people (aliens or other fictional characters).
Associated with other diseases
In psychotria, Fregoli's syndrome is closely associated with megalomania and persecution.
Today, the prevailing point of view is that this disorder is a type of Capgras syndrome, which includes the Fregoli delusion itself, the delusion of a positive and negative double, and the delusion of intermetamorphosis (the belief in the transformation of objects or people into other objects).
