Delusional Misidentification Syndromes: Untangling Clinical Quandary With the Newer Evidence-Based Approaches

Abstract

The delusional misidentification syndromes (DMS) have been described extensively in the descriptive literature of the last century given its unusual and often-distressing clinical presentations. In the last few decades, there have been advances in scientific research that have identified more precise brain areas involved in these delusional syndromes. Since DMS are reported in both early-onset psychosis and neurodegenerative conditions, the strategies to address and mitigate underlying etiology warrant a thorough assessment and individualized treatment planning. The age of onset, nature of the clinical presentation, the utility of diagnostic tests, and assessment of violence are few among many areas which need attention during clinical management of these rare syndromes.

Counterfactual cognition and psychosis: adding complexity to predictive processing accounts

“…I am surprised by her beard, she looks much more like a man than a woman, with a big nose" (Schwartz & Maquet, 2002, p. 29). As Wilkinson (2015) notes, this bears significant similarity to delusional misidentification, which often occurs in association with first-episode psychotic disorders (Jocic, 1992;Salvatore et al, 2014;Gupta et al, 2021). Of course, another cause of delusional misidentification, and, one might suppose, of loss of access to relevant counterfactuals underpinning the generative model, is localised brain damage.…”