COMMENTARY
Year : 2014 | Volume
: 7 | Issue : 1 | Page : 101--102
Capgras syndrome
Darpan Kaur
Department of Psychiatry, Mahatma Gandhi Missions Medical College, Kamothe, Navi Mumbai, Maharashtra, India
Correspondence Address:
Darpan Kaur
8/187, M.H.B., Om-Lamba Society, Opposite Bhakti-Dham Mandir, Sion-Chunabhatti, Mumbai-400 022, Maharashtra
India
How to cite this article:
Kaur D. Capgras syndrome.Med J DY Patil Univ 2014;7:101-102
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How to cite this URL:
Kaur D. Capgras syndrome. Med J DY Patil Univ [serial online] 2014 [cited 2023 Jun 4 ];7:101-102
Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2014/7/1/101/122806 |
Full Text
Introduction
Delusional misidentification syndrome includes Capgras syndrome, Fregoli syndrome, inter-metamorphosis, and the syndrome of subjective doubles. Until the past decade, these syndromes were considered extremely rare; however, an increasing number of cases are now being reported in literature. [1]
Epidemiology
Capgras syndrome can occur primarily in the setting of a schizophrenic illness, affective disorder, and organic illness.� [2] It is often associated with medical illness and should signal the treating clinician to investigate for organic conditions. [3] Capgras syndrome is relatively rare, occurring predominantly in the context of schizophrenia, and is traditionally considered to have its origins in the theory of psychodynamic conflict. Recent literature, however, highlights the estimated prevalence between 25 and 40% in the content of organic disorders such as dementia, head trauma, epilepsy, and cerebrovascular disease. [4]
Clinical Features
The person has a delusion that one or a few highly familiar people have been replaced by impostors who are physically very similar to the original/s. The patient may acknowledge that the double and known person look alike, but maintains the belief that the significant person, in psychological terms, is absent.
Typology
Capgras syndrome and the other syndromes are grouped together because they often co-occur and interchange, and their basic theme is the concept of the double (sosie). They are sometimes classified into hypoidentification syndrome (Capgras syndrome) and hyperidentifications (Fregoli syndrome, intermetamorphosis, and the syndrome of subjective doubles). [2]
Neurocognitive Overlay
The syndrome of Capgras is not only a dysfunction in facial recognition but in recognizing a person globally. The sense of feeling of familiarity is absent due to the inability to integrate successive memories about a person along episodic experiences. This hypothetically can generate delusional doubles in accordance to the patient's needs or drives.
Neurobiological Overlay
Capgras delusion arises from the failure in reconciling information about identification of the person and its associated emotions by the disconnection between frontal lobes and right temporo-limbic regions (hippocampus), in addition to bilateral frontal damage. Delusions are commonly associated with right hemisphere lesions because of the impairment of several functions such as self-monitoring, reality monitoring, memory, and feelings of familiarity. [5] Lesions are usually bifrontal and/or right hemispheric in delusion misidentification syndromes when neurological comorbidity occurs. Negative effects of right hemisphere injury impair self-monitoring, ego boundaries, and attaching emotional valence, and familiarity to stimuli. Cognitive style of categorization of the left hemisphere leads it to invent a duplicate or impostor to resolve conflicting information. Delusions in Capgras syndrome generally result from right hemisphere lesions; however, it is the left hemisphere that is deluded. [6]
Neurophysiological Overlay
Nowadays, event-related potentials, especially auditory P300 component, form a useful tool for providing information regarding the functions of the brain in Capgras syndrome. [1]
Current Research Scenario
Various types of misidentification syndromes have been recognized in recent literature. However, they tend to be discussed as case reports or as a whole. This may be primarily due to a small number of cases encountered by each researcher. [7] Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. [8]
Clinical Implications
Existing literature highlights the occurrence of Capgras syndrome in other nonpsychiatric organic conditions. It is extremely important to be aware of organic conditions that can present like Capgras syndrome. Relevant investigations and imaging may be performed to rule out organic basis. The clinician must consider standard psychopharmacological and psychotherapeutic interventions for the same.
References
| 1 | Warchala A, Krupka-Matuszczyk I. Delusional misidentification syndrome. Wiad Lek 2006;59:702-6. |
| 2 | Christodoulou GN, Margariti M, Kontaxakis VP, Christodoulou NG. The delusional misidentification syndromes: Strange, fascinating, and instructive. Curr Psychiatry Rep 2009;11:185-9. |
| 3 | Dohn HH, Crews EL. Capgras syndrome: A literature review and case series. Hillside J Clin Psychiatry 1986;8:56-74. |
| 4 | Edelstyn NM, Oyebode F. A review of the phenomenology and cognitive neuropsychological origins of the Capgras syndrome. Int J Geriatr Psychiatry 1999;14:48-59. |
| 5 | Madoz-Gúrpide A, Hillers-Rodríguez R. Capgras delusion: A review of aetiological theories. Rev Neurol 2010;50:420-30. |
| 6 | Devinsky O. Delusional misidentifications and duplications: Right brain lesions, left brain delusions. Neurology 2009;72:80-7. |
| 7 | Nishida H, Shinbo Y, Kuramitsu M, Motomura H. One possible classification of the delusional misidentification syndromes and its developmental, regressive understandings. Seishin Shinkeigaku Zasshi 1996;98:533-54. |
| 8 | Silva JA, Leong GB. The Capgras syndrome in paranoid schizophrenia. Psychopathology 1992;25:147-53. |
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