Delusional misidentification syndromes are divided into Capgras Syndrome, Fregoli Syndrome, Double Subjective Syndrome and Intermetamorphosis Syndrome. The main feature is an error in the identification of self and / or others. These entities are relatively rare and etiologically heterogeneous, occurring mainly in the setting of schizophrenic disorder, affective disorders and organic diseases.

About a clinical case of paranoid schizophrenia as a base, the authors revise and discuss the etiology and psychopathology of delusional misidentification syndromes presented by the patient.

Clinical interview with the patient during psychiatric hospitalization. Psychological assessment (test of intellectual performance, neurocognitive rating). Revision of selected literature about delusional misidentification syndromes and paranoid schizophrenia.

The neurobiological research on these syndromes indicates lesions both frontal lobes and / or right hemispheres.

The coexistence of three of the four existing Delusional misidentification syndromes is very rare. Based on the available literature, it appears that the described case is the only reported about the coexistence presented by same patient of Capgras Syndrome, Fregoli Syndrome, Double Subjective Syndrome and Intermetamorphosis Syndrome. Furthermore, the presentation is not typical due to the absence of previous psychiatric disorders, substance use or organic diseases.

The delusional misidentification syndromes seems to be under-diagnosed entities and poorly understood. Active research may allow a better understanding of clinical conditions like stated on the previous clinical case.