Delusions of Transformation of the Self

Abstract

A series of 20 patients suffering from delusions of physical and psychological transformation of the self is studied. Nosological, psychosocial, and biological aspects are discussed. Two cases are presented in detail.

Delusions of Psychological Change of the Self

“…This finding is in marked contrast to the syndrome of 'reverse' intermetamorphosis which does not appear to present with the substitution of religious identities [7], Delusions of psycho logical transformation resulting in an animal mind were not noted in our current series. However, delusions of psychological and physical metamorphosis into animals are fair ly common in the syndrome o f'reverse' inter metamorphosis, amounting to approximately 30% in a recent series [7], This markedly dif ferent pattern of resulting identity types be tween 'reverse' Capgras and 'reverse' inter metamorphosis delusions suggests that these two types of delusional misidentification of the self are two phenomenologically distinct entities.…”

“…These results differ from a sample of individuals with 'reverse' intermetamorphosis syndrome who claimed to be more aware of a metamorphosis, physical and psychological, that led to their new identity. In the intermetamorphosis sample, 75% en dorsed having undergone a slow metamor 287 phosis [7]. This finding suggests that the sub jective experiences of delusional misidentification differ in 'reverse' Capgras and 'reverse' intermetamorphosis syndromes and lends support to the idea that these two syndromes are phenomenologically distinct.…”

“…In contrast to this finding, 53% of 'reverse' intermetamorphosis subjects in a re cent series reported perceiving facial transfor mations when viewing themselves in the mir ror [7], Differences between perceived physical abnormalities in delusionally misidentified objects are also found between the syndromes of Capgras and intermetamorphosis [12,19,20]. Abnormal perceptions of misidentified objects are likely to influence a patient's belief in physical transformation and to contribute to the very definition of intermetamorphosis delusions of the self or others [7,20]. Whether or not a delusional misidentification is associ ated with visual abnormalities may derive from different neurologic substrates.…”

“…In this sys tem of classification, a syndrome of 'reverse' subjective doubles, or 'reverse' Capgras [3], refers to delusional misidentification of the mind of the self, while 'reverse' Fregoli syn drome refers to the delusional belief that the affected person undergoes radical physical changes ending in a new identity [4]. The syn drome of 'reverse' intermetamorphosis refers to the delusion that the self is undergoing radi cal changes in mental and physical makeup terminating in a new identity [2], The 'reverse' Frégoli syndrome appears to be very rare [4] while cases involving the syn drome of 'reverse' intermetamorphosis have been more frequently reported [5][6][7], Cases involving the syndrome of 'reverse' Capgras have been reported, but usually as single case studies [8,9],…”

An Unusual Case of Delusional Misidentification: ‘Delusional Hermaphroditism’

“…The patient's experience is different from that of 'reverse' intermetamorphosis. In Silva's et al [20] series of 20 cases, all the patients believed 'that they had undergone fundamental physical and psychological changes terminating in a new identity'. This is clearly different from Mr.…”