Biomedical subjects
Publications and source records attributed to H H Dohn.
The author reports a case of factitious rape in a psychiatric inpatient. To his knowledge, this is the first case report of this syndrome in the medical literature. This case is related to the signs and symptoms commonly found in Munchausen Syndrome. The question of the relationship of factitious rape to borderline personality disorder and to disturbed sexual identity is raised. Physicians are urged to develop an index of suspicion for factitious disorder.
The authors have presented a description and review of the Capgras Syndrome along with data from a case series of 25 patients with misidentification syndromes (24 Capgras Syndrome, 1 Fregoli Syndrome). From this data, the following conclusions can be drawn: The Capgras Syndrome is not a rare condition, but an uncommon one which is probably frequently overlooked. The misidentification syndrome is not important as a diagnostic entity. It appears in a variety of psychiatric and neurologic conditions. Capgras Syndrome appears to have a possible neurological link in clinicopathological studies; it has been correlated with lesions which produce prosopagnosia. Capgras Syndrome seems to occur more frequently in women, blacks and schizophrenics. Capgras Syndrome had a high (15%) incidence in our adult inpatients diagnosed as having schizophrenia. From this figure we estimate a 0.12% prevalence of Capgras Syndrome in the general population. Capgras Syndrome is often associated with medical illness and when found should signal the alert clinician to investigate for occult organic conditions.
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The study of flashback phenomena has been neglected in recent years. A case study and a subsequent literature review examine areas about which conflicting opinions exist. Epidemiological studies have not arrived at universally acceptable classificatory schemes. Clinical approaches vary in accounts of phenomenology of the syndrome and the typology of personalities involved. Etiology remains unknown in spite of numerous theories, most of them not experimentally tested. Diagnostic studies may benefit from recent technological advances such as continuous electroencephalogram, computerized axial tomography scan, cerebral blood flow, and neuropsychological tests. The Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, does not seem to provide an adequate taxonomic niche for this disorder. Therapeutic interventions are examined and their results critically analyzed.
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