Capgras delusion is a psychiatric disorder in which a person holds a delusion that a friend, spouse, parent, or other close family members (or pet) has been replaced by an identical impostor. People who experience the Capgras Delusion believe that these people have been substituted by doppelgangers or even robots and aliens who have crept into the flesh of unwitting humans. The delusion can also extend to animals and objects.
The delusion most commonly occurs in individuals diagnosed with paranoid schizophrenia but has also been seen in brain injury, dementia with Lewy bodies, and other dementia. It presents often in individuals with a neurodegenerative disease, particularly at an older age.
Capgras syndrome is named after Joseph Capgras, a French psychiatrist who, with a colleague, first described the disorder in 1923. It is one of several conditions classified as delusional misidentification syndromes (DMSs).
Causes, Sign, and Symptoms: The Capgras Delusion can arise in many settings. It can also develop in someone who sustains brain damage, like from a stroke or carbon monoxide poisoning. The delusion itself can be temporary or permanent. The first clues to the possible causes of the Capgras delusion were suggested by the study of brain-injured patients who had developed prosopagnosia.
One theory is that Capgras syndrome results from a brain injury involving lesions on the brain. Capgras syndrome could also be caused by a disconnect between the visual part of the brain and the area that processes facial familiarity.
Other theories suggest that underlying conditions, such as dementia or Alzheimer’s disease, may be the cause. These illnesses alter how a person perceives the world around them and remembers things.
Schizophrenia and epilepsy are also believed to be potential causes or co-occurring conditions. A 2015 study looked at a case of Capgras syndrome that was related to hypothyroidism, or an underactive thyroid gland, so hormonal imbalances may also be a risk factor.
Symptoms of Capgras syndrome can be perplexing and frustrating for both the person affected and those around them. The most obvious symptom of Capgras syndrome is when someone starts to believe that a person close to them is either a double or has been replaced by someone else.
Diagnosis and Treatment: It is a rare and poorly understood condition; there is no definitive way to diagnose the Capgras delusion. Diagnosis is primarily made on the psychological evaluation of the patient, who is most likely brought to a psychologist’s attention by a family member or friend believed to be an imposter by the person under the delusion.
If the Capgras Delusion is one of the multiple symptoms resulting from a particular disorder like schizophrenia or Alzheimer’s, common treatments for those disorders, like antipsychotics for schizophrenia or medications that help boost memory for Alzheimer’s, may help. In the case of brain lesions, the brain could eventually reestablish the connections between emotion and recognition.
Treatments for underlying conditions vary widely, but may include:
- memory and recognition medications
In some cases, validation therapy may be useful. Validation therapy focuses on someone accepting the misidentification to help them relax and reduce anxiety.
Some people with Capgras syndrome may never achieve a full recovery. However, caregivers and family members can help reduce their loved one’s symptoms, including anxiety and fear.
Anyone experiencing or witnessing the symptoms of Capgras syndrome should speak to a doctor as soon as possible.