Nurturing Syndrome Converting to Fregoli Delusion : A Case of Right Middle Cerebral Artery Territory Infarction

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  • Chiba Tomoko
    Department of Neuropsychology, Southern TOHOKU Research Institute for Neuroscience.
  • Sato Mutsuko
    Department of Neuropsychology, Southern TOHOKU Research Institute for Neuroscience.
  • Motoki Chihiro
    Department of Rehabilitation, Southern TOHOKU DAINI Hospital Miharu Southern TOHOKU Rehabilitation and Care Center
  • Kaneko Chikako
    Department of Neurology, Southern TOHOKU Research Institute for Neuroscience

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  • Nurturing 症候群がフレゴリの錯覚に移行した右中大脳動脈領域梗塞の 1 例

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Abstract

<p>  Nurturing syndrome is a psychopathologic phenomenon characterized by delusional beliefs and abnormal behaviors consistent with the idea that a deceased loved one remains alive. The mistaken belief that a dead person still lives in this world has been reported not only in nurturing syndrome but also in some cases of the Fregoli delusion. However, the relationship between the two syndromes has rarely been discussed. We report one case in which nurturing syndrome had converted to Fregoli delusion. The case was a 75-year-old right-handed woman who had lost her husband eight years earlier. She was admitted to our hospital because of infarction in the right middle cerebral artery territory. While in a private hospital room, she presented nurturing syndrome in which she continued to behave as if her husband were still alive. Next, when she moved to a rehabilitation hospital and had opportunity to meet male patients, she began to misidentify them as her husband and developed Fregoli delusion. We interpreted both syndromes as a result of autobiographical memories about her husband, the emotional responses evoked by these memories, and psychological factors such as the desire to rely on her husband. Notably, maintenance of the irrational belief that the deceased husband was still alive was thought to be linked to right frontal dysfunction. The clinical course suggested that nurturing syndrome in this case may have converted into Fregoli delusion when there were men of similar age with her husband. This is the only case we know of in which nurturing syndrome has evolved into Fregoli delusion, indicating a close relationship between the two syndromes.</p>

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