barw Judi Clinical Journal 3105-4102 1 2 2025 11 25 Fregoli Syndrome: A Case Report and Literature Review 122 125 10.70955/JCJ.2025.15 eng Yadgar N. Abbas Shahid Doctor Hemn Psychiatric Hospital, Qanat Street, Sulaimaniyah, Iraq Fattah H. Fattah Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Hemin S. Mohammed Xzmat polyclinic, Rizgari, Kalar, Sulaymaniyah, Iraq Meer M. Abdulkarim Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Jihad I. Hama Research Center, University of Halabja, Halabja, Iraq Amr M. Mahmood Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Hussein M. Hamasalih Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Shvan H. Mohammed Kscien Organization for Scientific Research (Middle East Office), Azadi Mall, Hamdi Street, Sulaymaniyah, Iraq Berun A. Abdalla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq 0000-0001-5638-4128 2025 08 20 Introduction: Fregoli syndrome is a rare misidentification disorder that can disrupt behavior, endanger safety, and impair quality of life. Its occurrence in young adults is exceptionally uncommon. This report presents a case of Fregoli delusion in a young adult without the usual underlying causes, such as schizophrenia. Case presentation: A 25-year-old male presented with a two-month history of persecutory delusions, believing that strangers, friends, and professors were disguising themselves to follow and harass him. His psychiatric history was unremarkable, and there was no family history of mental illness. The patient was diagnosed with Fregoli delusion and prescribed Risperidone 2 mg/day, alongside cognitive-behavioral therapy to challenge his delusions. After three months of treatment, he showed gradual improvement, with reduced intensity of delusions but occasional paranoid thoughts. Literature review: Seven cases of Fregoli delusion were reviewed. Patient ages ranged from 43 to 77 years, with predominant female prevalence (71.4%). Psychiatric histories included delusional schizophrenia, paranoid schizophrenia, and unspecified psychiatric conditions. Medical histories included hypertension, myocardial infarction, Parkinson’s, and diabetes mellitus. Presenting symptoms varied with delusional misidentification, auditory/visual hallucinations, suicidal ideations, delirium, and paranoia. Treatment approaches included risperidone alone or in combination with electroconvulsive therapy, aripiprazole & promazine, and more. Symptom improvement was seen in four cases, and one case achieved full resolution of symptoms. Conclusion: Fregoli syndrome is a rare condition of multiple etiologies that can present in young patients. Risperidone, combined with cognitive behavioral therapy, may yield fruitful results.