Capgras Delusion Syndrome
Capgras delusion syndrome (also known as “look-alike illusion syndrome”) is a rare psychiatric illness characterized by the delusional belief that one or more people have been replaced by look-alikes who persecute the patient.
This is an identification delirium that requires specialized psychiatric management.
What is Capgras delusion syndrome?
Capgras syndrome was first described in 1923 by a French psychiatrist Joseph Capgras. It is a psychiatric illness that belongs to the family of psychoses, in particular delusions of identification.
Even if the person recognizes the face of the interlocutor, they are convinced that it has been replaced by a doppelganger:
This syndrome is often associated with schizophrenia, dementia, even diabetes, hypothyroidism or brain trauma.
It affects women a little more often than men (2 men for 3 women).
The patient thinks that his relatives have been replaced by impostors who want him harm. This is only the case when he looks at their faces, but not when he hears their voices.
The main cause of this syndrome is thought to be a brain dysfunction between the area of visual recognition and that of emotion and memory.
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Whenever he looks at the face of his loved one, the patient does not recognize it and thinks it is a new person. These hallucinations are then false perceptions that he considers to be real.
Characteristics of Capgras syndrome
Capgras syndrome is characterized by the delusional belief that one or more loved ones have been replaced by their evil doubles. It usually appears gradually (or suddenly if it follows a traumatic brain injury) and then becomes chronic.
The symptoms of Capgras syndrome
The unwavering belief that these relatives have been replaced by look-alikes (the “sosification”).
A delirium of persecution and the belief that there are conspiracies.
Aggression towards these “impostors”.
Lack of awareness of the disorder (anosognosia).
In most cases, the illusion is on family members (spouse, parents, children), but sometimes on pets, objects, or places.
Unlike prosopagnosia, the patient recognizes familiar facial features, places or objects well. This is an anomaly in their affective and emotional perception.
Capgras delusion syndrome: what treatment?
Capgras syndrome is a psychiatric illness requiring specialized treatment by a psychiatrist. It is very often associated with another psychiatric illness, such as schizophrenia or dementia. However, the first symptoms sometimes appear up to 20 years after the onset of psychosis.
The course will depend on the associated pathology:
- In the case of psychoses, it depends closely on the intellectual level.
- In dementias, the symptoms gradually decrease.
- Some cases may involve thousands of “dumbfounded” people.
- When the disease in question can be cured, the syndrome goes away.
- Neuroleptics are drugs prescribed by the psychiatrist, needed to decrease delusional belief, reduce anxiety and aggressiveness.
Hospitalizations of varying lengths are often necessary and placement in an institution when the autonomy and safety of the patient and those around him are compromised by the disease.
Causes
The causes can include organic lesions (stroke, dementia, metabolic disorders, intoxication) functional disorders (mental disorders).
The main psychiatric diagnosis associated with Capgras syndrome is that of schizophrenia (54%). Mood disorders (depression, mania, bipolar disorder) are less frequently associated. Then come schizoaffective disorders.
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