Fregoli Syndrome is a very rare illness in which an individual believes that many different people are in fact the same person. This condition was named after the Italian actor Leopold Fregoli. Fregoli was renowned for his ability to make abrupt changes in his appearance during his various stage acts.

It was first reported in 1927 by psychiatrists who analyzed a case study of a 27 year old female who believed she was being persecuted by two different actors who were in the theater, which she saw frequently. She held the belief that these people “pursued her closely, taking the form of people she knows or meets [1].”

An individual who suffers from Fregoli Syndrome can also (inaccurately) recall specific events, objects, and even places. Fregoli Syndrome can be explained by what are called “associative nodes”. Essentially, these associative nodes serve as a type of biological link of information about other individuals that have a particular familiar face (to the patient). This basically means that for any human face that’s similar to a recognizable face of the patient, the patient will recall that face as the person they know [2].

Causes of Fregoli Syndrome

Fregoli Syndrome is a very debilitating mental illness where the individual experiencing it lives in a state of delusion of near constant paranoia and tension. There is not a wealth of knowledge on the cause of Fregoli Syndrome. Nevertheless, this syndrome may in fact be related to a brain lesion and is usually of a paranoid nature, with the delusional individual believing themselves persecuted by the person that they believe is in disguise [2].

Though unclear, it is very possible for someone who suffers from Schizophrenia to also experience the symptoms of Fregoli Syndrome. This may not come as a surprise due to fact those who suffer from Schizophrenia are typically very paranoid. So, it would not be unfeasible to envision someone experiencing psychosis, along with the delusion that there is also someone they know or who they’ve seen before who is dressing up in disguise in an attempt to somehow persecute them.

Symptoms of Fregoli Syndrome

The symptoms of fregoli syndrome are very distinct and are very distressing for the individual experiencing them and can cause anxiety. This is so due to the delusion of seeing other people as the same person.

Someone suffering from Fregoli Syndrome actually believes that the same person is going out of their way to change their appearance throughout the day with unconcievably convincing disguises. And this is all meant as a means to stalk them or cause them some sort of harm. There is really no limit as to what fears they feel that all of the different “impostors” may actually be capable of. Below, you’ll see some trademark symptoms of Fregoli Syndrome:

  • Belief that other people are the same person
  • Belief that other people are persecuting them
  • Paranoia of the “impostors” they see
  • Out of touch with reality
  • May inaccurately recall events, objects, or places

Fregoli Syndrome Diagnostic Criteria

To get diagnosed with Fregoli Syndrome, you will need to get a psychiatric evaluation from a psychiatrist or psychologist. The mental health professional will look at the symptoms the individual is experiencing to see if they meet the criteria for getting diagnosed with Fregoli Syndrome. In addition to this, the mental health professional will determine how debilitating that these symptoms have been in the individual’s life, as well as for what length of time these symptoms have plagued them.

Treatments for Fregoli Syndrome

After it has been confirmed that the individual has Fregoli Syndrome, then it is likely that drugs will then be prescribed. Typically, anti-psychotic drugs are among the first type of drugs for the treatment of Fregoli Syndrome. In addition to anti-psychotics, anti-depressants and anti-convulsants may also be prescribed to treat some of the symptoms of Fregoli Syndrome. If a Fregoli patient has other psychological disorders, treatment often results in the use of trifluoperazine [2].

Trifluoperazine is used to treat specific mental/mood disorders (e.g. schizophrenia, psychotic disorders). Trifluoperazine helps you by allowing you to think more clearly, feel less anxious, and experience everyday life with less distress [3].

Upon receiving a psychiatric evaluation, it may bring light to other mental illnesses in addition to this syndrome. It would not be perspicacious to also explore the possibilities that someone diagnosed with Fregoli Syndrome could then also be diagnosed with Schizophrenia as well.

This is especially relevant due to the fact that a typical symptom of schizophrenia is feeling out of touch with reality. Regardless of this, a complete psychiatric evaluation, as well as a thorough analysis of their family’s history with mental illness (if there is a history) will need to be looked at so the mental healthcare professional can truly create an effective treatment plan for them.


1) “The Fregoli Syndrome.” Glenn Miller MD.
2) “Fregoli Delusion.” Wikipedia.
3) “Trifluoperazine HCL.” Web MD.