What is Capgras syndrome
Capgras syndrome is characterized by a delusional belief that a person, usually a close relative or friend, has been replaced by an imposter with very similar features as the original person 1). Capgras syndrome has been described in psychiatric and neurological (neurodegenerative and nonneurodegenerative) diseases.
Capgras syndrome was described almost a century ago named after the French psychiatrist who described “the illusion of doubles” 2). Capgras syndrome is characterized by the recurrent and transient (ranging from minutes to months) belief that a person, usually someone closely related, has been replaced by an imposter. The imposter usually has features that are very similar to those of the original person 3), although subtle physical differences are used to differentiate the original person from the imposter 4).
Capgras syndrome is assumed to be a rare phenomenon initially reported to be associated only with psychiatric diseases, including paranoid schizophrenia 5) and schizoaffective disorder 6). However, more recently Capgras syndrome has also been described in neurological conditions including epilepsy 7), in cerebrovascular disease 8), after head trauma 9), with pituitary tumor 10), and especially in neurodegenerative diseases such as Alzheimer disease 11) and Lewy body disease 12). However, it is unknown whether there are differences between Capgras syndrome that occurs in neurodegenerative compared with nonneurodegenerative diseases, or whether there are differences in Capgras syndrome when it occurs in different neurodegenerative diseases.
Capgras syndrome causes
The underlying neurologic cause of Capgras syndrome is unknown, some researchers theorize that it is caused by increased dopamine levels due to life stressors or medications, whereas others believe that brain lesions are a possible cause 13). Capgras syndrome occurs most often in patients with schizophrenia, although it has also been reported in patients with dementia or epilepsy, as well as in patients who have experienced traumatic brain injury. Capgras syndrome is commonly associated with neurodegenerative diseases, especially Lewy body disease, where visual hallucinations always coexist 14). In the absence of a neurodegenerative disease, the onset of Capgras syndrome occurs at a significantly younger age and can be associated with psychiatric disease, cerebrovascular events, and illicit drug use 15).
more recently Capgras syndrome has also been described in neurological conditions including epilepsy 16), in cerebrovascular disease 17), after head trauma 18), with pituitary tumor 19), and especially in neurodegenerative diseases such as Alzheimer disease 20) and Lewy body disease 21). However, it is unknown whether there are differences between Capgras syndrome that occurs in neurodegenerative compared with nonneurodegenerative diseases, or whether there are differences in Capgras syndrome when it occurs in different neurodegenerative diseases.
Capgras syndrome symptoms
Capgras syndrome is characterized by a delusional belief that a person, usually a close relative or friend, has been replaced by an imposter with very similar features as the original person 22).
Capgras syndrome treatment
There are limited studies on the efficacy of treatments for Capgras syndrome 23). Capgras syndrome is usually managed through treatment of the underlying disorders and typically involves antipsychotic medications. However, cognitive-enhancing treatments and nonpharmacologic strategies that diminish disorganization should be used in patients with dementia 24).
References [ + ]
|1, 14, 15, 22.||↵||Capgras syndrome and its relationship to neurodegenerative disease. Josephs KA. Arch Neurol. 2007 Dec; 64(12):1762-6. https://www.ncbi.nlm.nih.gov/pubmed/18071040/|
|2.||↵||Capgras J, Reboul-Lachaux J Illusions des sosies dans un delire systematise chronique. Bull Soc Clin Med Ment 1923;ii6- 16|
|3.||↵||Todd J, Dewhurst KWallis G The syndrome of Capgras. Br J Psychiatry October1981;139319- 327|
|4.||↵||Frazer SJ,Roberts JM Three cases of Capgras’ syndrome. Br J Psychiatry 1994;164 (4) 557- 559|
|5.||↵||Christodoulou GN The syndrome of Capgras. Br J Psychiatry June1977;130556- 564|
|6.||↵||Silva JATekell JLLeong GBBowden CL Delusional misidentification of the self associated with nondominant cerebral pathology. J Clin Psychiatry 1995;56 (4) 171|
|7, 16.||↵||Drake ME Jr Postictal Capgras syndrome. Clin Neurol Neurosurg 1987;89 (4) 271- 274|
|8, 17.||↵||Collins MNHawthorne MEGribbin NJacobson R Capgras’ syndrome with organic disorders. Postgrad Med J 1990;66 (782) 1064- 1067|
|9, 18.||↵||Benson DFGardner HMeadows JC Reduplicative paramnesia. Neurology 1976;26 (2) 147- 151|
|10, 19.||↵||Sumners D Believing your husband has been replaced by an impostor because you have a pituitary tumour. Br Med J (Clin Res Ed) 1984;289 (6446) 699- 700|
|11, 20.||↵||Cummings JLMiller BHill MANeshkes R Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol 1987;44 (4) 389- 393|
|12, 21.||↵||Roane DMRogers JDRobinson JHFeinberg TE Delusional misidentification in association with parkinsonism. J Neuropsychiatry Clin Neurosci 1998;10 (2) 194- 198|
|13.||↵||Ferguson MR, Yu CK, Poliakov AV, Friedman SD, McClellan JM. Capgras syndrome: neuroanatomical assessment of brain MRI findings in an adolescent patient. Brain. 2017;140:e43.|
|23.||↵||Sampathi BR, Sofine A, Alvarez J, Bota R. Capgras syndrome in substance-induced psychosis. Ment Illn. 2018;10(2):7807. Published 2018 Nov 6. doi:10.4081/mi.2018.7807 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240921/|
|24.||↵||Rare and Unusual Psychiatric Syndromes: A Primer. https://www.medscape.com/viewarticle/899520|