Capgras Syndrome
Capgras Syndrome
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Original abstract
Capgras syndrome (CS), or delusion of doubles, is a delusional misidentification syndrome. It is a syndrome characterized by a false belief that an identical duplicate has replaced someone significant to the patient. In CS, the imposter can also replace an inanimate object or an animal. Contrary to the earlier belief that CS mainly affects women, it occurs in both genders. It is widely regarded as the most prevalent of the delusional misidentification syndromes and appears in psychiatric and non-psychiatric cases, including patients with brain damage. Brain damage in the bifrontal, right limbic, and temporal regions can cause CS. This brain damage leads to aberrant memory functions, self-monitoring, and reality perception. Such neurophysiological deficits cause an inability to integrate emotional information processing and facial recognition correctly. Besides schizophrenia and schizoaffective disorders, Alzheimer disease (AD), dementia, Lewy body dementia, epilepsy, cerebrovascular accident (CVA), pituitary tumors, and advanced Parkinson disease (PD) patients can experience CS. De Clerambault syndrome and Ekbom syndrome patients may also experience CS. The propensity of violence in CS patients requires its speedy recognition and timely intervention. Diagnostic and Statistical Manual of Mental Disorders (DSM) Classification CS has not been addressed within the DSM-5 because of its rare nature. It suits either the persecutory or unspecified delusion type. Historical Perspective CS is named after Joseph Capgras, a psychiatrist of French origin. In 1923, Joseph Capgras first defined the disorder in a paper that reported a case of a French-origin woman who complained that corresponding doubles had replaced her husband and other persons she knew. The woman also believed that there existed a double of herself. The authors referred to this syndrome as "I'illusion des sosies," which translates to mean "the illusion of look-alikes." Initially, CS was regarded as a psychiatric disorder, similar to delusions in schizophrenia. CS was connected to hysteria as seen predominantly in females. Berson explained that CS differed from hallucinations, illusions, memory losses, perceptual malfunctions, and disorientation. In the 1980s, organic brain lesions were identified in patients with CS. Today, CS is understood to be a psychiatric and neurological disorder in which the delusion primarily emanates from organic brain degeneration.