Delusional memory, confabulation, and frontal lobe dysfunction: A case study in De Clérambault's syndrome

Abstract

Abstract Delusional memories can be indistinguishable from spontaneous confabulations, except for the context (psychosis; organic amnesia) in which they arise. There is substantial evidence that ‘frontal lobe’ or ‘executive’ dysfunction is the setting in which spontaneous confabulations arise, and that schizophrenic patients show impairments on ‘frontal lobe’ and memory tasks. A neuropsychological case-study was conducted in a patient with prominent delusional memories, secondary to De Clérambault's syndrome (‘erotomania’) and schizophrenia. The patient showed a moderate degree of anterograde memory impairment, relative to her high verbal IQ. She showed a ‘dip’ in her retrograde memory test performance for the period around the onset of her psychosis, but otherwise retrograde memory was intact. Performance at ‘frontal lobe’ or ‘executive’ tasks was completely intact. In summary, frontal lobe (or executive) dysfunction does not appear to have contributed to this patient's delusional memory, although she did show a moderate degree of anterograde memory impairment, consistent with other studies of schizophrenic patients. Possible differences in the underlying nature of delusional memory and spontaneous confabulation are discussed.