A misidentification ritual in a patient with obsessive-compulsive disorder: clinical and pharmacotherapeutic implications

Misidentification of self, others, places, time, and objects occurs in a large number of medical or psychiatric conditions. Misidentification syndromes have been rarely reported in patients with primary non-psychotic conditions. The subjects with obsessive-compulsive disorder (OCD) may present unusual and rare symptoms. In this case report, we present an OCD patient who exhibited a misidentification ritual to decrease his anxiety arising from horrific images of someone assaulting his wife and children. He substituted the face of assailant with the faces of three different previously known individuals. For this case, we supposed that this ritual was related to an autogenous obsession and also was associated with schizotypal personality traits. To our knowledge, this is the first case exhibiting misidentification rituals related to non-delusional violent images in a patient with OCD.