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Syndrome of Subjective Doubles: Delusions of Identity and Duplication

Summary

A 23-year-old man believed that a musician he saw on social media was actually his identical duplicate, causing him significant distress and confusion about his own identity. His belief that he might be the ‘dead’ version persisted for years until he sought psychiatric help due to worsening symptoms. Treatment with the antipsychotic medication olanzapine, combined with therapy, successfully reduced his delusions and hallucinations within five days of hospitalization. This rare condition highlights how certain psychiatric disorders can cause profound disturbances in how people perceive their own identity.

Background

The syndrome of subjective doubles is a rare subtype of delusional misidentification syndromes where patients believe duplicates of themselves or others exist with distinct intentions or characteristics. This condition is associated with psychiatric and neurological disorders and was first described in 1978 by George N. Christodoulou.

Objective

This case report aims to describe a 23-year-old patient experiencing the syndrome of subjective doubles centered on the belief that a musician on social media is identical to him, and to raise awareness of this rare disorder with poorly understood etiology.

Results

The patient initially adamantly believed the musician was his duplicate, but with olanzapine 5 mg nightly, showed progressive improvement over five days. Auditory hallucinations subsided completely, delusions significantly diminished, and paranoid ideation resolved by discharge. The patient was discharged on olanzapine with outpatient follow-up planned, though he was subsequently lost to follow-up.

Conclusion

Syndrome of subjective doubles is an extremely rare disturbance of self-identity that can co-occur with schizophrenia. Treatment with antipsychotics like olanzapine effectively reduced symptoms, supporting the need for personalized treatment approaches and further research into the role of substance use in triggering these syndromes.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 40352053, DOI: 10.7759/cureus.81975
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