Dangerous Delusions of Misidentification of the Self

Abstract

Delusions of misidentification of the self involve radical misidentification of physical and/or psychological aspects of the self. These delusions have received limited attention from a phenomenological as well as from a forensic psychiatric perspective. In this article we present a series of four cases of dangerous delusional misidentification of the self and discuss important factors that may contribute to their dangerousness.

Capgras Syndrome: A Review of the Neurophysiological Correlates and Presenting Clinical Features in Cases Involving Physical Violence

“…Kennedy and others found that patients who had committed violent or threatening acts demonstrated fear and anger toward the misidentified person (130). By contrast-as in 3 of our 4 cases -patients tend to demonstrate a blunted affect or emotional distance toward the person believed to have been replaced (26,117,129) and appear emotionally detached when speaking of their violent action (13).…”

“…Numerous reports exist of cases of violent behaviour in CS sufferers (for example, 13,107-117). We summarize 4 cases involving CS and severely violent acts; these add to a growing number of reports indicating that individuals with CS can pose significant danger to others (13,108,109,113,114,117,118). The individuals in our case series had a court-ordered psychiatric assessment and were evaluated either in a detention centre or in a forensic assessment unit.…”

“…Affective state may be an important clinical feature in evaluating the potential for violence among patients with CS. There are frequent reports of patients showing strong feelings of hostility toward the imagined imposter (26,117,129). Kennedy and others found that patients who had committed violent or threatening acts demonstrated fear and anger toward the misidentified person (130).…”

Psychiatric Illness Presenting with a Sexual Complaint and Management by Psychotropic Medications: A Case Report

“…DMS has been associated with Alzheimer's disease and parkinsonism [2]. In a recent study, Silva et al reported that DMS may occur in reference to the patient's own identity [1]. In such a case, in the reverse type of DMS, the affected person experiences erroneous physical and/or psychological attributes that are radically different from their objective identity, which leads the patient to believe he or she is a different person [1].…”

Suicide Associated With the Antichrist Delusion

“…Religious delusions may also present in the context of a misidentification state in which an individual believes that physical and/or psychological identities of others or of the self have changed radically leading to a new personal identity (2,3). Rarely such patients may misidentify themselves or other persons as the Antichrist, a condition of particular importance because violent behaviors are often associated with this delusion (2,(4)(5)(6). Presented here is the case of a female patient who committed suicide secondary to the Antichrist delusion.…”