Fregoli's syndrome, or delirium of Fregoli, is a mental illness that got its name in honor of the Italian comedian of the late XIX - early XX centuries, known for his talent for reincarnation. People with this pathology are subject to persecution mania. Moreover, they are convinced that they are constantly pursuing them, and the pursuers themselves are extremely cunning (up to the point that they are able to change their appearance beyond recognition). People with Fregoli syndrome can see a threat in an ordinary adult, a small child, an animal, and even inanimate objects (trees, stones, etc.).
Etiology of the disease
There may be several reasons for the appearance of Fregoli syndrome. Usually, an x-ray of the brain reveals the presence of some kind of organic component, which affects the functioning of the entire nervous system, causing malfunctions. Any visual information first falls into a spindle-shaped gyrus, where the distinction begins between living and non-living objects. The processed result through the third path goes to the amygdala, which is responsible for the emotional state. Therefore, if there is damage to part of the fibers, the patient is able to demonstrate positive and negative reactions, however, the connection "perception-emotion" is broken.
Today, a number of psychiatrists are inclined to consider Fregoli's nonsense as 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 having suffered a traumatic brain injury of both open and closed type.
Symptoms
The main symptom of Fregoli syndrome is that the patient considers strangers his acquaintances who are stalking him. In this case, the patient is well aware of all the differences in appearance, but ignores those at the psychological level. Nonsense Fregoli is often correlated with schizophrenia. The patient believes that he is hypersensitive, and therefore can determine who or what a person or object is in reality, no matter how well disguised.
Such a patient can talk about his own power, reinforcing it with greatly exaggerated or fictitious examples. However, delirium is not permanent. A man always comes up with new events, not forgetting the details. At the same time, he does not prove his words in any way, since he is infinitely convinced of his own rightness. Sometimes there are talks about reading thoughts 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 syndrome are:
- persecution mania;
- hypersensitivity;
- megalomania;
- physical pains.
Pathology Features
The course of the disease is closely associated with pseudo-hallucinations, confabulation and retrospective delusions. Under the influence of the latter, the patient can overestimate his life in connection with a new worldview.
The impact of confabulation is wider, since the events of the past are already intertwined in the patient's mind with his sick fantasies. This affects the ability to remember downward. In addition, a person is disoriented in space. There are changes in emotional terms. The patient is either in an elevated or manic state.
Depression with delirium Fregoli occurs less frequently. For him, acute paraphrenia is more characteristic - vivid hallucinations associated with hypersensitivity and unstable confabulations. Against this background, the nonsense is fantastic.
Sometimes the catatonic syndrome is manifested separately - a failure of the motor system, expressed as inhibition or excitement. If the disease goes into the chronic stage, the person is under a stable delirium, always hiding from the “enemies” and fearing the invasion of his refuge.
Diagnosis of Fregoli syndrome
To make a diagnosis, the psychiatrist determines which type of delirium prevails in the patient (whether there are fantastic thoughts, delusions of persecution or greatness, etc.).
You can talk about a chronic disease if the patient demonstrates a constant delusional state, is constantly hiding from “persecution” and checks his home for “intrusion”.
Fregoli syndrome treatment
For the patient, the emotional background that family members create is extremely important. It is not worth explaining to such a patient, especially in the acute stage, that he is wrong and that he is not in danger. This will only worsen the situation. Assistance and support will be right. It is worthwhile to go around the house with him, together to make sure that there is no "danger".
If pathological perception is uniform, then we can talk about the development of schizophrenia. Moreover, the manifestation of a double symptom indicates a paraphrenic form. However, the treatment regimen remains the same for both cases.
Therapy of Fregoli delirium can take several years. Prediction of the disease depends on many factors. Of great importance is the duration of the patient's stay without qualified assistance. The prognosis is also affected by the presence of other mental illnesses.
Examples of recorded cases
For the first time, P. Kurbon and J. Feil wrote about this disease in 1927. Their article spoke of a young woman who often visited the theater. She believed that she was constantly haunted by actors who were making up under her friends.
One of the patients suffering from persecution mania was convinced that when he visited certain places, he was constantly followed by a person who took the form of a casual passer-by, a schoolboy, and even a sparrow. At the same time, another feature characteristic of Fregoli syndrome was manifested - antagonism. This patient saw in the surrounding not only "enemies", but also "his". And for each group a clear role was assigned. "Enemies" tirelessly pursue, and "their" - provide support. For example, if the “pursuer” comes too close, “his” will force him to leave.
Patients with delusions Fregoli often demonstrate mental automatism in fantastic content. Many can mentally talk with famous people or someone non-existent (aliens or other fictional characters).
Relationship with other diseases
In psychotria, Fregoli syndrome is closely associated with delusions of grandeur and delusions of persecution.
Today, the prevailing point of view is that this disorder is a variant of Kapgra syndrome, which includes Fregoli’s delirium, delusions of a positive and negative double, as well as delusions of intermetamorphosis (the belief in turning objects or people into other objects).