Towards a redefinition of dissociative spectrum dimensions inside Capgras and misidentification syndromes in bipolar disorder: Case series and literature review

Abstract

IntroductionMisidentification phenomena and Capgras Syndrome (CS) occur in different psychiatric (psychotic or major affective illnesses) and neurological (traumatic brain injury, epilepsy, neurosyphilis, etc.) disorders [1,2]. The aim of this report is to redefine dissociative spectrum dimensions inside CS and misidentification syndromes in patients with Bipolar Disorder (BD).MethodFive inpatients were assessed with the SCID-P, SCID-DER, DSS, HRSD, YMRS, a neurological and general medicine review, a first-level brain imaging examination (CT and/or MRI). We conducted a systematic literature review (PubMed, Embase, PsychInfo) using the key terms “Capgras Syndrome” and “Misidentificaition”.ResultsAll patients were diagnosed with type-I BD and had concomitant CS that presented with misidentification phenomena in the context of psychotic mixed state. They reported high scores for autopsychic and affective depersonalization symptoms as well as high SCI-DER (mean = 24.4) and DSS (mean = 13) total scores.Discussion and conclusionTo our knowledge in literature, there are not studies that evaluated dissociative spectrum symptoms in CS in BD. This condition of identity and self fragmentation could be the key to shedding light on the interconnection between affective and non-affective psychotic disorders from schizophrenia to BD, and may underscore the possible validity of the concept of the unitary psychosis proposed by Griesinger [3–5]. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations are considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.