Margariti Maria M, Kontaxakis Vassilis P
Department of Psychiatry, Medical School, University of Athens, Eginition Hospital, Athens, Greece.
Psychopathology. 2006;39(6):261-8. doi: 10.1159/000095730. Epub 2006 Sep 8.
Co-occurrence of the different types of delusional misidentification syndromes (DMS) implies a common pathogenetic substrate. Until now, theoretical explanations have strained to produce a collective approach, but have been trammeled by the initial definition of the syndromes (Capgras/Fregoli) that originated from the attribution of causal significance to the element of familiarity towards the misidentified object. In this article, we present two cases illustrating the co-occurrence of the syndromes and we attempt to propose a new approach to DMS. We hypothesize that a common potential pathogenetic factor underlying DMS could be a disorder of the sense of uniqueness. The ability to attribute uniqueness to the self and to surrounding people, objects, or places is a principal property of the adaptable mind that acts as a matrix for the identification process. We propose that although the term 'identity' encompasses the concept of uniqueness, this must be accomplished somewhere in a model of semantic processing of identity. Our approach is questioning the current view that this sequential stage is the PIN stage in the functional model of face recognition by Bruce and Young, and we attempt to see the disordered sense of uniqueness within the evolved form of the model of face recognition and delusional misidentification introduced by Ellis and Lewis. We propose that such a disturbance could result in an unstable identification process, vulnerable to discrepancies in perceptual, emotional, or memory input caused by psychotic or organic mental states, thus resulting in a breakdown of the identification process that inevitably leads to a delusion of denial of identity, or to a delusion of 'doubles'.
不同类型的妄想性错认综合征（DMS）同时出现意味着存在共同的致病基础。到目前为止，理论解释一直试图提出一种综合方法，但却受到这些综合征（卡普格拉/弗雷戈里）最初定义的限制，这些定义将对被错认对象的熟悉感这一元素赋予了因果意义。在本文中，我们展示了两个说明这些综合征同时出现的病例，并试图提出一种针对DMS的新方法。我们假设，DMS潜在的共同致病因素可能是独特感障碍。将独特性赋予自我以及周围的人、物体或地点的能力，是适应性思维的一个主要属性，它是识别过程的基础。我们提出，虽然“身份”一词包含独特性的概念，但这必须在身份语义处理模型的某个地方得以实现。我们的方法对当前的观点提出了质疑，即这个顺序阶段是布鲁斯和杨的面部识别功能模型中的PIN阶段，并且我们试图在埃利斯和刘易斯提出的面部识别及妄想性错认模型的演进形式中看待紊乱的独特感。我们提出，这种干扰可能导致识别过程不稳定，容易受到由精神性或器质性精神状态引起的感知、情感或记忆输入差异的影响，从而导致识别过程的崩溃，不可避免地导致身份否认妄想或“替身”妄想。
