Clonal pluralization, as an interpretative delusion after a hallucinatory form of autoscopy

Abstract

Background and Objectives: Delusional misidentification syndromes are widely present in several major psychiatric and neurological disorders. After reviewing the recent terminology and psychopathology of the double phenomenon in the literature, the authors present a case of a patient with dementia, vascular type, where clonal plural- ization of the Self appeared as a secondary, interpretative delusion after a hallucinatory type of autoscopic experience. Methods: Review of the literature and a case report. Results: In the presented case the linear evolution and the interpretative aspect of the arising misidentification phenomena are predominant. The differential diagnosis and the distinctive characteristics of the presented case from other potential delusional misidenti- fication syndromes are also discussed. Brain lesions and neuropsychological impairments seem necessary, but the full development of these syndromes depends upon the individ- ual's responses to his or her defects as much as the defects themselves. Conclusions: Overviewing the broad spectrum of concepts on delusional misidentifica- tion syndromes, the authors emphasize the importance of those approaches which enhance the disappearance of the classical organic-functional dichotomy on the double phenomenon and which try to clarify the neurocognitive background of delusional misidentifications.