Mental Health A-Z What Is the Fregoli Delusion? By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on October 27, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Praetorianphoto / Getty Images Table of Contents View All Table of Contents History Signs Identifying Causes Other Types Treatment Coping The Fregoli delusion is a rare psychiatric condition characterized by a false belief that different people are in fact the same person. People with the Fregoli delusion often believe that a particular person, usually someone they don't know, is following them and impersonating other people. The delusion can be quite distressing, leading to feelings of paranoia and anxiety. There is no known cure for the Fregoli delusion, but treatment may help lessen symptoms and improve quality of life. History of the Fregoli Delusion The Fregoli delusion was first described in 1927 by French authors Courbon and Fail. They reported the case of a woman who believed that two famous actresses of the time (Sarah Bernhardt and Robine) were taking on the guise of different people such as friends, employers, and strangers in the street. Courbon and Fail named the delusion after Italian actor Leopoldo Fregoli because of his ability to impersonate people on stage. Signs of the Fregoli Delusion A person experiencing the Fregoli delusion will often believe that a certain person is following them and impersonating other people. This person is usually someone they don't know, and the delusion can be quite distressing. The person may also have feelings of paranoia and anxiety. Below are specific symptoms of the Fregoli delusion: Feeling that someone is pretending to be someone else in order to harm you Feeling that someone is following you Feeling paranoia and anxiety Feeling that different people are actually the same person Identifying the Fregoli Delusion The Fregoli delusion is a rare psychiatric condition, so it can be difficult to diagnose. A mental health professional will likely perform a psychological evaluation to rule out other conditions with similar symptoms. They may also ask about any recent trauma or look into potential brain disorders. In general, the diagnosis of the Fregoli delusion is made when other conditions have been ruled out and the person has persistent delusions about being followed by someone who is impersonating other people. Causes of the Fregoli Delusion The exact cause of the Fregoli delusion is unknown. However, it is believed to be linked to certain brain disorders, such as schizophrenia and dementia. It may also be triggered by a traumatic event, such as abuse or a major loss. Below are the potential causes of the Fregoli delusion: Schizophrenia: This is a mental disorder that can cause delusions and hallucinations. People with schizophrenia may believe that people are following them or impersonating others. Dementia: This is a brain condition that can lead to changes in thinking and behavior. People with dementia may have delusions, such as the belief that someone is following them. Traumatic brain injury: This can cause changes in thinking and behavior. People with a history of brain injury may be more likely to have delusions, such as the Fregoli delusion. Other mental disorders: Conditions like depression, anxiety, and bipolar disorder may also lead to delusions. Other Types of Delusional Misidentification Syndromes The Fregoli delusion is one of four types of delusional misidentification syndromes. These syndromes are characterized by a false belief that someone is impersonating another person. The other three types are the following: Capgras delusion: This is the belief that a loved one has been replaced by an impostor.Intermetamorphosis delusion: This is the belief that different people are actually the same person who periodically changes appearance.Subjective doubles: This is the belief that you have a doppelgänger or a copy of yourself. Treatment for the Fregoli Delusion There is no known cure for the Fregoli delusion. However, treatment may help lessen symptoms and improve quality of life. Treatment options include medication, therapy, and support groups: Medication: Medication can help lessen symptoms of the Fregoli delusion, such as paranoia and anxiety. Antipsychotic medications such as aripiprazole and olanzapine are often used to treat delusions. Therapy: Therapy can help a person manage their condition and cope with the stress of the Fregoli delusion. Cognitive behavioral therapy (CBT) is one type of therapy that may be helpful. In this type of therapy, the person works with a therapist to challenge their false beliefs. Support groups: Support groups can provide a space for people with the Fregoli delusion to share their experiences and connect with others who understand what they're going through. Through this support, people may feel less alone and more hopeful. If you think you or someone you know may be experiencing the Fregoli delusion, it's important to seek professional help. The condition can be quite distressing, and treatment can help lessen symptoms and improve quality of life. Coping With the Fregoli Delusion The Fregoli delusion can be a very distressing condition. In addition to seeking professional help, there are things you can do to cope with the condition. Here are some tips: Educate yourself: Learning about the Fregoli delusion can help you better understand your condition and what you're experiencing. This knowledge can also empower you to advocate for yourself and make informed choices about your treatment. Stay connected: Lean on your support system of family and friends. Spending time with loved ones can help reduce stress and make you feel more connected. Practice self-care: It's important to take care of yourself both physically and mentally if you're coping with the Fregoli delusion. Consider things like getting regular exercise, eating a healthy diet, and getting enough sleep. Practicing relaxation techniques, such as yoga or meditation, may also be helpful. A Word From Verywell The Fregoli delusion is a rare and distressing condition. If you think you or someone you know may be experiencing the condition, it's important to seek professional help. Treatment can help lessen symptoms and improve quality of life. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Langdon R, Connaughton E, Coltheart M. The Fregoli delusion: a disorder of person identification and tracking. Top Cogn Sci. 2014;6(4):615-631. doi:10.1111/tops.12108 Courbon P, Fail G. Syndrome d"'illusion de Frégoli" et schizophrénie [Syndrome of the "illusion of Fregoli" and schizophrenia]. Bulletin de la Société Clinique de Médecine Mentale. 1927:20;121–125. Kumar PNS, Gopalakrishnan A, Williams M. A case of Fregoli syndrome in schizophrenia. Asian J Psychiatr. 2018;36:119-120. doi:10.1016/j.ajp.2018.07.003 Cipriani G, Vedovello M, Ulivi M, Lucetti C, Di Fiorino A, Nuti A. Delusional misidentification syndromes and dementia: a border zone between neurology and psychiatry. Am J Alzheimers Dis Other Demen. 2013;28(7):671-678. doi:10.1177/1533317513506103 Feinberg TE, Eaton LA, Roane DM, Giacino JT. Multiple fregoli delusions after traumatic brain injury. 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