Capgras and Fregoli delusions are psychotic complex conditions that integrate a larger group of Delusional Misidentification Syndromes (DMS), where the patient misidentifies people, places or objects.

Review of the literature and exposure of a case report of a first psychotic episode with DMS.

Case report and a nonsystematic review through databases. With the keywords: Capgras; Fregoli; DMS.

This case presents a caucasian male, 34-year-old, with no personal or family history of psychiatric pathology. He was taken to the emergency service, due to behavior disorder with verbal aggressiveness to his mother. During the psychiatric emergency he was restless, with accelerated speech and presented Capgras and Fregoli delusion. He believed that his mother had been replaced by an imposter and that the doctor was actually his childhood friend disguised, all with the intention of harming him. The patient was hospitalized, analytical and brain scan show no abnormally. Improvement in symptoms was been seen when a long-term injectable antipsychotic was started. The diagnosis was Bipolar type I disorder.

DSM are more frequent than previously considered, they often occur in association with psychiatric or neurological disorders. Case reports like this one helps to clarify the association between DMS and psychiatric disorders. Given the high incidence of DMS, it is essential to recognize them, carry out an early treatment and be alert to other psychopathological or neurological symptoms that may coexist.

No significant relationships.

The delusional misidentification syndromes (DMS) are uncommon but fascinating neuropsychiatric disorders. One particularly intriguing form of DMS is called the mirror sign or mirror delusional misidentification (MDM).

We aim to present a case on MDM and a review on MDM and its correlation with neurological lesions.

Non-systematic review of the literature and case report.

A 72 years old patient was admitted to the emergency department with disorientation, behavioral changes and persecutory delusional ideation. The patient was also unable to recognize his face in the mirror, claiming to be his son. On neuroimaging tests, the patient presented with moderate diffuse cortical-subcortical cerebral atrophy associated with mild diffuse cortical cerebellar atrophy, as well as atheromatous calcifications in carotid siphons. In the MDM, the patient treats the mirror image as separate from the self. It is commonly seen in patients with dementia. Unlike Capgras syndrome, MDM is typically associated with neurological illness, particularly with neurodegenerative conditions. Findings on neuroimaging have shown a pattern of right hemisphere cortical and subcortical lesions. the most common findings included the following: generalized or localized atrophy on Magnetic Resonance Imaging, ventricular dilatation on Computed Tomography scan, and slowing on Electroencephalography.

Mirror delusional misidentification differs from other forms of DMS as it is seen exclusively in patients with neurological disease. While right hemisphere dysfunction appears to be a requirement for MDM, patients with this condition do not show consistent enough neuroimaging findings to allow for a localization within the right hemisphere.

No significant relationships.

Capgras syndrome (CS), the most common type of delusional misidentification syndrome, is the delusional belief that significant people in the patient's life have been replaced by identical doubles. Capgras syndrome is thought to be a rare syndrome which commonly occurs in a psychotic context.

The objective of this study was to estimate the 5-year prevalence rate of CS in a university hospital in-patient setting and determine associated etiological and sociodemographic factors.

All patient files and medical records were reviewed in detail for the presence of Capgras syndrome. The sociodemographic variables, clinical manifestations, and psychiatric and medical diagnoses of patients who fulfilled clinical criteria for Capgras syndrome were recorded for statistical evaluation.

The retrospective evaluation of patient files in 920 cases admitted to our psychiatric in-patient unit over 5 years revealed that 12 patients fulfilled the criteria for Capgras syndrome. The crude prevalence of Capgras syndrome in this population during 5-year period was 1.3% (1.8% for females, 0.9% for males). Schizophrenia (50%) was the most common psychiatric diagnosis in these patients. Only two patients presented with an organic etiology underlying Capgras syndrome.

The results of this study indicate that Capgras syndrome is not a rare syndrome, and commonly occurs during the course of either functional or organic psychotic illness. Age seems to be an important predicting factor for the etiology of psychosis underlying Capgras syndrome.