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Concept
Mirrored-self misidentification
Summary
Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is another person – typically a younger or second version of one's self, a stranger, or a relative. This delusion occurs most frequently in patients with dementia and an affected patient maintains the ability to recognize others' reflections in the mirror. It is caused by right hemisphere cranial dysfunction that results from traumatic brain injury, stroke, or general neurological illness. It is an example of a monothematic delusion, a condition in which all abnormal beliefs have one common theme, as opposed to a polythematic delusion, in which a variety of unrelated delusional beliefs exist. This delusion is also classified as one of the delusional misidentification syndromes (DMS). A patient with a DMS condition consistently misidentifies places, objects, persons, or events. DMS patients are not aware of their psychological condition, are resistant to correction and their conditions are associated with brain disease – particularly right hemisphere brain damage and dysfunction.
Delusional misidentification syndromes (DMS) can occur in patients with a wide variety of cranial dysfunctions. Mirrored-self misidentification, a type of DMS, occurs most typically in patients with dementia, especially Alzheimer's disease. Approximately 2% to 10% of all patients with Alzheimer's disease have mirrored-self misidentification. Patients with schizophrenia, right frontal ischemic stroke, and rarely patients with Parkinson's disease have also reported being affected by this delusion. The exact prevalence of patients with this delusion is relatively unknown because the typical patient has many comorbidities; this makes it difficult to separate the symptoms of mirrored-self misidentification from other existing psychological conditions. Furthermore, a standard neurological or neuropsychological workup tends to overlook the existence of this delusion because affected patients have extensive cognitive degeneration that is the main focus of medical attention.
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