Review: The Delusional Misidentification Syndromes: Strange, Fascinating, and Instructive

The paper reviewed here is ‘The Delusional Misidentification Syndromes: Strange, Fascinating and Instructive’ by Christodolou and colleagues. This is a brief overview of the Delusional Misidentification Syndromes (DMS), a collection of syndromes in which the person holds delusional beliefs about the identify of another person, people or object(s). George Christodoulou has significant experience in this area having authored an article on this as far back as 1978 in which he first described and named the syndrome of subjective doubles. The collective familiarity of the authors with the DMS’s is demonstrated by their extensive references to the occurrence of the DMS in mythology and literature. The four DMS’s are described as Capgras Syndrome (in which familiar people are believed to have been replaced by doubles), Fregoli Syndrome (in which a stranger is recognised instead as a familiar person), Intermetamorphosis Syndrome (in which the familiar person and the other person have the same psychological and physical identity and can swap places) and the Syndrome of Subjective Doubles (in which the person believes that other people physically transform into themselves). The authors then cover a number of explanatory models for the DMS’s including agnosia of identification secondary to mismatching of sensory input and memories, defence mechanisms (e.g. projection and splitting), ‘regression to archaic modes of thought’, dysfunction in the right cerebral hemisphere (as well as a similarity to the reduplicative phenomenon), Bruce and Young’s adaptation to a face-processing model, Young’s interactionist model and Coltheart’s two-stage model. The article is succinct and the authors expertly navigate through this esoteric field which spans nearly 100 years. Perhaps a neat unifying theory may not be forthcoming given the considerable variation in phenemonology, comorbidity and sequalae and the field may settle with a number of successful explanatory models with identifiers for their use. Christodoulou and colleagues have written a concise and useful overview of the field which includes some of the most recent models for those interested in the Delusional Misidentification Syndromes.


G.N.Christodoulou et al. The Delusional Misidentification Syndromes: Strange, Fascinating and Instructive. Current Psychiatry Reports. 2009. 11. 185-189.


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  1. Thank you for this concise and accurate review of our article.
    The Delusional Misidentification Syndromes are currently very much “in fashion” because of the redublication phenomena depicted in films, TV and scientific fiction. From the clinical point of view they are interesting as markers of organicity.
    The sundrome of subjective doubles that I have described may be related to autoscopy and represent a delusional elaboration of autoscopic experiences.
    Jean-Pierre Luaute from France has studied the DMS and we have published together a paper in French on the syndrome of Doubles of the self.


    • Dear Professor Christodolou,

      Thank you very much for your comments and it is a great privilege to hear your feedback on this review. I have been reading around the subject of Delusional Misidentification Syndromes for some time and I have found your papers on this subject very interesting particularly the relationship to the P300 component of ERP’s. Many thanks again




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