Fregoli delusion(Symptoms & Treatment Options)

This article is a detailed overview of fregoli delusion and discusses some pertinent aspects related to this disorder.

Also, this article reveals possible symptoms, diagnostic aspects and possible treatments that offers insight into this problem.

Fregoli delusion is one of the interesting delusional discrepancies, according to which the inflicted individual believes that the people around him/her are not different or unique, rather they are a single person who has been changing appearance or adopt a disguise. 

A Peek into History & Origin of Fregoli Delusion

Also termed as Fregoli syndrome, this very misconception was initially discovered by scientists in the early 1927.

In the streets of Paris during the initial times of the year 1927, a patient came out to a couple of psychiatrists living in the neighborhood. 

As the Parisian patient opened up about her trouble of assuming different characters portrayed by the very same person, the psychiatrists came to a halt.

These psychiatrists, Courbon and Fail were so flabbergasted to know about the patterns of their patients, since such claims were never made in the history before by any participant. 

The Parisian patient made startling commands regarding her favorite actresses, Robine and Sarah Bernhardt being the same person eventually who just tend to switch disguises in order to fool out their employers and friends wandering on the boulevards casually.

The patient was so much irritated by these everyday events and judgements that once she even tried to tackle a total stranger on the street presuming that the respective person was actually a heckler trying to prank her into something.

Whereas another case was reported in light of this respective event, in which an aged woman complained about her friend and cousin sharing the same identification.

She assumed that both these people were concealing themselves with different wigs, facial masks in order to follow her around the streets.     

The doctors, medical experts termed the illness as ‘Fregoli delusion”.  Named after a famous Italian star/personality Leopoldo Fregoli, who impersonated, mimicked people in order to entertain the audience in the early age of 19th century.

And that is how the origination of the disordering illness, delusion came into being.

What is Fregoli Delusion all About?

In the above mentioned cases, both the patients shared the same pattern about wrongly identifying the person who shares familiarity with disguised character.

For instance, the patient might be able to correctly identify that the stranger is an unacquainted individual. 

However, these individuals are erroneously termed as being someone they are familiar with or a known personality.

Such as the Parisian patient examined by the psychiatrists was fully aware of the famous personality – Sarah Bernhardt, who she saw at a theatre on some days of the week complained about seeing her again on the streets cloaked as a complete stranger while also following the patient around in order to bring her harm. 

God has gifted humans with a wild imagination.

We tend to meet several people from time to time in our lives, each of them holding different features and skills yet we identify them as soon as our gaze fall on their appearance.

Humans have this amazing capability to differentiate all sorts of things due to their embedded sense of identification and recognition. 

Even after being gifted these capabilities and certain functioning patterns, there is still some room available for disruptions within.

It is possible that through some psychological events or traumas could lead a person to disrupt respective capabilities of figuring prominent people in their day to day life.

Therefore, the occurrence of Fregoli delusion is not an inherited illness or an embedded dysfunctionality instead its prominence is associated with certain psychological traumas or disruptive behavioral patterns due to damage in the peripherals of the brain. 

This illusion termed as Fregoli delusion or syndrome is basically a rarely occurring disorder where the bearer occupies an unrealistic certainty that distinct individuals or strangers around them are in fact familiar faces who just tend to change their disguise.

In fact not only but also the participants exhibiting Fregoli delusion might get clustered when it comes to places, location, occurrences or pieces. 

Fregoli delusion illness is basically categorized under the banner of delusional misidentification syndromes (DMS) where it has been causing challenges to various medical examiners who have been unable to determine as to what triggers this experience in vulnerable patients.     

Hypothetical convention surrounding Fregoli delusion 

As per normal hypothetical reaches, a disruption within the nervous system or peripherals of the brain is the root cause giving birth to Fregoli delusion.

But this reach is only one sided.

There are basically 3 hypotheses that have been presented in order to deduce as to what actually triggers the presence of Fregoli syndrome among patients. 

Ellis and Young’s module:

Actually, the first bunch of people who ever presented a module or a model of explaining the pattern Fregoli syndrome among patients belong to Ellis and Young.

They did not only presented a binary module for explaining the behavioral pattern referring to Fregoli delusion, but also Capgras delusion which is associated with the participant frequently believing that their close persons have been replaced by some sort of mimicker or a hoaxer.  

Ellis and Young basically laid out a design where they pitched that the experience or triggering phenomenon leading to Fregoli delusion might be occurring due to the similarities between the stranger and the familiar person. 

However, Ellis and Young failed to contemplate a solid backup theory as to why only a single stranger amongst a crowd was wrongly labeled as a recognized individual or character.   

Ramachandran and Blakeslee’s module:

The module belonging to Ramachandran and Blakeslee suggested that instead of similarities found in the people, the delusion was much more associated with neuropathological responses.

Their hypothetical respect basically referred to a complete different dimensional aspect relating to Fregoli syndrome.

Ramachandran and Blakeslee presented that in reality patients enduring Fregoli syndrome own a “hyperactive temporo- limbic” context that tends to rail between amygdala and the countenance recollection system. 

This connection between systems tend to trigger sentimental stimulation among the individuals. 

To lay out a clear understanding, their design proposed that these individuals nervous system was met with agitated responses.

Although, Ramachandran and Blakeslee were still not clear as to what prompts these overexcitement within the participants.  

As per Ellis and Young’s statement, this sentimental stimulation was experienced during the dearth of conscious identification belonging to familiar countenance in the surrounding therefore, causing the phenomenon that a known person is lingering around the patients while being disguised.  

However, the module presented by Ramachandran and Blakeslee is not fully established fact since it failed to proffer solid evidence against the factor that the sentimental arousal within nervous system would eventually lead to multiple faces being recognized as a disguised person entirely and not only a single person in the crowd. 

Hirstein module 

While according to Hirstein module, an idea was developed that wrongly identifying or Fregoli delusional concerns are caused by mismatches between “internal depictions” and “external depictions” of the second person’s physical manifestations.

These internal depictions could include traits, attitude, desires and emotional states of the participants enduring Fregoli syndrome.   

Major causes contributing to Fregoli syndrome 

There are generally 2 most important factors or causes leading to endurance of Fregoli delusion among rare individuals. 

Distressing brain damage 

As per the research conducted by various medical professionals, it was deduced that any damage to left and right frontal peripheral of the brain can give rise to Fregoli delusion.

It has been reported that due to these injuries in the left and right peripheral of the brain, loss of managerial and essential memory could take place sooner or later. 

Different levels of tests were conducted on patients who had undergone brain damage, which revealed that the rudimentary concentration and processing rate was typical.

Although these patients were not able to pass the comprehensive attention assignments through which it was deduced that the patients were deficient in reticence and responsive control.     

Curing Levodopa 

Several medical reports suggested that the use of levodopa contributed to the hallucinatory delusions among participants or patients.

During the course of levodopa treatment, it was reported that the delusional patterns tended to overgrow therefore seizing the entire bandwidth of the participants attention. 

However, the decrement in the dosage of levodopa also contributed in decrementing delusional patterns in the patients.

Therefore, it is deduced that Fregoli delusion is commonly occurring illness found in the antiparkinsonian treatments. 

There are multiple signs associated with Fregoli syndrome that are highlighted below: 

  • Interrupted seizures 
  • Outbreaks of epilepsy 
  • Scarcity of visual recollection
  • Hallucinatory patterns 
  • Lack of control over oneself 
  • Experiencing pathological distress
  • No self-control over abrupt thoughts and bewilderment  

Treating Fregoli syndrome

As per to date, no proper treatment tends to be available in the medical market for Fregoli delusion.

However, certain antidepressants are prescribed to the patient along with antipsychotic medications in order to reduce the effects related with the hallucinatory patterns. 

Fluoxetine and venlafaxine are some commonly known antidepressants which can be arranged for the patient enduring Fregoli syndrome other than that anticonvulsant drugs can also be offered to the patients. 

As per recent searches on delusional misidentification syndrome, the theory still remains debated due to the perpetual similarity with psychosomatic maladies such as obsessive compulsive and bipolar disorder.

There are still many questions that have not been answered and founded related to Fregoli syndrome, delusional patterns which causes the matter to relay in the space for the time being. 

Some Helpful Resources

  1. Reversing Fregoli Delusion: Deficiencies The Raw Vegan Plant-Based Detoxification & Regeneration Workbook for Healing Patients. 
  2. Debunking Delusions: The Inside Story of the Treatment Action Campaign
  3. Psychotherapy for Psychosis: Integrating Cognitive-Behavioral and Psychodynamic Treatment
  4. Cognitive Therapy for Delusions, Voices and Paranoia
  5. Enlighten Me: A Practical and Comprehensive Guide to Mental Illness, Addiction, and Treatments


Fregoli delusion is an interesting category of delusional disorders and may pose a challenge in treatment because of limited understanding of the overall psychopathology of this disorder.

Therefore, it is of utmost importance to seek professional help to improve the prognosis and recuperate from the debilitating aspects of this disorder. 


Q) What causes Fregoli delusion?

A) The delusion might be related to disruptions occurring in the brain that can be of paranoid nature.

The delusion might lead the participant to believe that a strange face might be a familiar face while being disguised in the crowd. 

What is Fregoli syndrome? it is a rarely occurring illness where the bearer occupies a unrealistic certainty that distinct individuals or strangers around them are in fact familiar faces who just tend to change their disguise

Q) Can it improve with age?

A) No, as per recent researches conducted by medical professionals, no proper treatment has been put forth in order to solve the delusional problem.

However, antidepressants can be prescribed to the patient for curing the associative measures with the syndrome. 

Q) Is it inherited?

A) No, Fregoli syndrome is not an inherited problem.

Actually the syndrome can be caused due to traumatic events or injuries to the brain. 

Q) Is Fregoli syndrome dangerous?

Fregoli syndrome itself is not a threatening illness.

However, the delusional patterns might cause an outbreak among participants due to disruptions within the peripherals of the brain.  

Q) What are its symptoms ?

A) some of the commonly occurring symptoms are: Interrupted seizures, outbreaks of epilepsy, scarcity of visual recollection, hallucinatory patterns, lack of control over oneself, no self-control over abrupt thoughts and bewilderment, and many more. 

Q) What is the delusion thinking?

A) actually, both Fregoli syndrome and Capgras syndrome comes under the banner of DMS but in reality both are different concerns.

Capgras illusion which is associated with the participant frequently believing that their close persons have been replaced by some sort of mimicker or a hoaxer.   


Science Direct