Exotic Psychiatric Syndromes: From Alien Hand Syndrome To Munchausen By Proxy

Certain conditions are seldom encountered by mental health professionals, and they may even need a modest refresher course to recognize and manage them. Most of us, however, have met at least one person who has a condition on this list of ten exotic mental health diagnoses.

Capgras Syndrome

Capgras syndrome, named after a French psychiatrist who first described the delusion of body doubles, is a psychiatric condition of misidentification. People who suffer from Capgras syndrome suffer the erroneous belief that another person, usually a close family member or a spouse, has been replaced by an impostor.

It is usually treated with antipsychotic medications although dementia patients may be treated with talk therapy to diminish mental disorganization.

Fregoli Syndrome

Fregoli syndrome was named after the Italian actor Leopoldo Fregoli, who was famous for his ability to change costumes in the middle of a play. Fregoli syndrome is the converse of Capgras syndrome. In this condition, there is a delusion that people close to the patient can assume the guise of strangers, or may "double" as angels, secret agents, the therapist, or the patient.

Like Capgras syndrome, Fregoli syndrome usually occurs in schizophrenics, although it can occur along with dementia, brain injury, or a seizure disorder. It is usually treated with antipsychotic medications.

Cotard Delusion

The Cotard delusion was named after French psychotherapist Jules Cotard, who identified a  le délire de négation or a delusion that one has already died, or does not exist, or has decaying internal organs. One variation of the condition is a belief that one is invisible to others (but not as a superpower). This delusion is usually managed by treating the schizophrenia or other psychiatric or neurological problem accompanying it.

Reduplicative Paramnesia

Neurologist Arnold Pick, an early twentieth century investigator of Alzheimer's disease and other forms of dementia, identified a condition similar to Capgras syndrome only involving a belief that a place, rather than a person, has been duplicated, calling it reduplicative paramnesia. People who have this condition may believe that their current homes, childhood homes, or significant places have been copied and exist simultaneously in two locations. It is more common in people who have Alzheimer's or some other form of dementia, and usually is not managed separately from the underlying disease.

Alien Hand Syndrome

Alien hand syndrome is a belief that one's hand does not belong to the body and has its own life. The patient may claim "My hand did it," or refused to do something, taking no responsibility or ownership for the actions the patient makes with the hand.

See Also: Freak Conditions: Not A Laughing Matter

This condition most commonly occurs in people who have damage to the corpus callosum, which connects the left and right hemispheres to the brain, after stroke or traumatic brain injury.

More Exotic Psychiatric Problems

Alice in Wonderland Syndrome

Alice in Wonderland syndrome, also known as Todd syndrome, is a condition caused problems in the way the brain processes visual information. In this condition, the sufferer may experience bizarre distortions of size, shape, and color. There may be micropsia, belief that the surrounding world is tiny, or macropsia, belief that one is surrounded by giant objects and people. The condition usually does not occur all the time, although there may be attacks several times a day.

The condition often improves with rest, or with the use of a group of medications known as calcium channel blockers or another group of medications known as beta-blockers. It may also be necessary to strictly avoid foods that trigger migraine attacks.

Dissociative Fugue

A dissociative fugue is a temporary inability to recall personal history, especially the facts surrounding a traumatic event. The latest edition of the Diagnostic and Statistical Manual, the DSM 5, classifies this condition as a subset of dissociative amnesia, which is not limited to the inability to recall traumatic events. Dissociative fugue usually occurs in the context of severe stress, whether physical or emotional, and is usually treated with supportive therapy rather than with drugs.

Foreign Accent Syndrome

In foreign accent syndrome, an individual speaks his or her native language as if she had a foreign accent. 

Stockholm Syndrome

In 1973, a group of bank customers taken hostage during a bank robbery in Stockholm developed an unusual attachment to their kidnappers, cooperating with, identifying with, and helping them despite the fact they were victimized by them. This mindset came to be known as Stockholm syndrome, a profound psychological reorganization that takes place under extreme stress. In the bank robbery case, the kidnapped customers refused to testify against the captors even after the robbers were caught and the customers were released. The next year, kidnapped newspaper heiress Patty Hearst took part in a robbery organized by her kidnappers. Stockholm syndrome is usually addressed by talk therapy and by treatment of any other concurrent psychiatric conditions.

See Also: Foreign Accent Syndrome: Does It Really Exist?

Lima Syndrome

Lima syndrome is the opposite of Stockholm syndrome. In Lima syndrome, victimizers become sympathetic to the wishes and needs of their victims. In 1996, fourteen terrorists associated with the Tupac Amaru Revolutionary Movement in Peru took several hundred business executives, diplomats, and Peruvian military officers and government officials hostage at the residence of the Japanese ambassador to Peru. Unexpectedly, within a few day, the terrorists had released most of their captives, including the mother of the then-president of Peru and a future president of the country. After months of negotiations, all but one hostage was eventually released. For obvious reasons, Lima syndrome is usually not treated. It is believed to result from guilt, moral indecision, or failure to adapt to stress.