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Syndrome of subjective doubles as a rare presentation of a first-episode psychosis
  1. Joao Luis Martins Quarenta1,
  2. Cláudia Mota Pinto2,
  3. Catarina Pedro Fernandes3 and
  4. Pedro Morgado3,4,5
  1. 1Psychiatry, Hospital Padre Américo Vale do Sousa SA, Penafiel, Portugal
  2. 2Psychiatry, Hospital Beatriz Angelo, Loures, Lisboa, Portugal
  3. 3Psychiatry, Hospital de Braga, Braga, Braga, Portugal
  4. 4Life and Health Sciences Research Institute (ICVS), School of Medicine, Universidade do Minho, Braga, Braga, Portugal
  5. 5ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
  1. Correspondence to Professor Pedro Morgado; pedromorgado{at}


In this paper, we report the case of a man in his 30s with a first-episode psychosis, characterised by a subtype of delusional misidentification syndrome in which the delusion of doubles is exclusively of the patient’s own self. This subdivision can be termed ‘syndrome of doubles of the self’ or ‘syndrome of subjective doubles’. Additionally, an examination of the patient’s mental state showed paranoid delusions. After being evaluated in the emergency department, the patient was hospitalised, and medicated with antipsychotic drugs. One week later, he was discharged with total remission of psychotic symptoms. This is a rare and curious presentation of a psychotic episode, with very few similar cases described to date.

  • Drugs: psychiatry
  • Psychotic disorders (incl schizophrenia)
  • Drugs misuse (including addiction)

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  • Contributors JLMQ, CMP and CPF contributed equally to this paper. PM, JLMQ and CMP were involved in the clinical diagnosis and patient's initial care. CPF is involved in the subsequent follow-up of the patient. JLMQ, CMP and CPF authors drafted the manuscript. PM substantially contributed to its revision as did JLMQ, CMP and CPF.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests PM has received in the past 3 years grants, CME-related honoraria, or consulting fees from Angelini, AstraZeneca, Bial, Biogen, DGS-Portugal, FCT, FLAD, Janssen-Cilag, Gulbenkian Foundation, Lundbeck, Springer Healthcare, Tecnimede, Viatris and 2CA-Braga.

  • Provenance and peer review Not commissioned; externally peer reviewed.