Capgras Syndrome. Symptoms, Causes and Treatment

He Capgras Syndrome Is a psychic disorder that affects the ability of patients to recognize their own friends or family. The person who suffers from it believes that their loved ones have been replaced by impostors.

Ellis and Lewis in a Article Published in Trends in Cognitive Sciences , The patient may also come to believe even that family and friends have been replaced by robots or aliens.

Capgras Syndrome

Other names that are given to this type of hallucination are delusion of sosias ("illusion des sosies") or illusion of the doubles.

This variety of delusional false recognition syndrome (FRD) was first described in 1923 by psychiatrist Jean Marie Joseph Cagras, who is named after him and by his collaborator Jean Reboul-Lachaux.

It can occur in men and women of almost all ages, although according to Gordon (2013) it is more frequent in women.

Symptoms of Capgras Syndrome

The most common symptom and the one that defines the Capgras Syndrome is the vision of doubles that have replaced important people in the patient's life. Those who suffer from it often think that these doubles are bad.

In 2013, pediatric neurologist J. Gordon Millichap published a guide on some neurological syndromes, including Capgras, Neurological Syndromes: A Clinical Guide to Symptoms and Diagnosis. It contains the characteristics of this mental disorder and some keys to detect it through physical and psychic signs that the patient presents. According to Gordon, this disease mainly affects brain And to the face.

The rest of symptoms are associated with the same false belief generated by the Capgras Syndrome and have to do with the behavior of the person who suffers.

One of the key features to distinguish it from other disorders that affect the ability to identify and recognize, is convinced that the patient is his own delirium. For many explanations that can be given by the relative or friend qualified as impostor, the affected will not believe.

Of course, the paranoias are also very present, since who suffers the disappointment of Capgras believes that the double disguised of a loved one wants to hurt him. This is one of the peculiarities that differentiates Capgras Syndrome from other delusional false identification syndromes such as Frégoli .

Another characteristic of the Capgras Syndrome is that it does not have to be with all the beings that surround the affected person, but can be oriented to a single person from the patient's environment.

According to one document By Feinberg and Roane on the False Delusional Recognition In Capgras Syndrome replication is common. That is, for example, the patient denies the identity of the loved one and defends the existence of two different people, the real and the impostor.

Finally, delirium only occurs with those with whom an emotional bond has been established in an earlier situation.

Causes that can lead to Capgras Syndrome

Capgras Syndrome is not as rare as it sounds, although it is rare. In fact, as Dohn and Crews wrote in 1986 in a Article published in The Hillside Journal of Clinical Psychiatry , Is often overlooked.

The reasons for Capgras syndrome may be diverse, although it is usually related to previous development of other diseases or certain neurological or psychiatric circumstances.

In this sense a dissertation Of Robert Berson on the Capgras Syndrome, states that there must be some paranoid characteristics or a previous psychotic situation. It can also be caused by dysfunctions that have occurred in previous social relationships, even in stages such as childhood.

One of the situations cited by Berson as the cause of delirium is the schizophrenia . Referring to this, Dohn and Crew note in a 1986 review that I quoted at the beginning that the incidence of Capgras Syndrome in patients with schizophrenia is 15% higher than in those who do not suffer from this mental illness.

Gordon, in his guide to neurological disorders, picks up some of the physical and mental health problems that are often associated with Capgras Syndrome. Some of these abnormalities in the functioning of the organism are schizophrenia, which I have already named, brain damage, dementia, neurodegenerative damage or parts of the body. cerebral cortex As the Frontal lobe .

Josephs speaks in a investigation Published in 2007 in Archives of Neurology Of the relationship between Capgras Syndrome and neurodegenerative damage. In this study it was verified that of 47 patients analyzed, 81% suffered damage that affected the associated neuronal degeneration. In most cases this damage was the Dementia of Lewy bodies , Whose symptoms are usually the Cognitive impairment , Slowness of movement and Hallucinations .

This study provides another very important fact, and is that in younger people these delusions of doubles are caused by other diseases of psychiatric treatment or by illicit use of drugs.

Another of the main causes in the Gordon guide is a possible disconnect between the part of the brain associated with facial recognition, the temporal lobe, and the limbic system , Responsible for the physiological responses to the emotions.

It is this aspect that differentiates Capgras Syndrome from Prosopagnosia , Since in the first case the autonomous facial recognition capability is not affected. For example, those who suffer from the Illusion of sosia know that the face of the person they are seeing is that of their spouse or other family member, what fails is the emotional connection, which makes him think that it is not the true one. On the other hand, the prosopagnostics, at first, do not recognize the face of their near beings. This is what Ellis and Lewis (2001) collect.

Finally, the doctor states that in some cases he may also be associated with hypothyroidism, diabetes or migraine or with the use of some medications such as Ketamine , Mainly used to induce general anesthesia.

In relation to this cause, Stewart presents in a Article of the Southern Medical Journal , The case of a man of 67 years who developed the Capgras Syndrome as a result of a reaction to Diazepam , A drug commonly used to treat anxiety.

Are these hallucinations treated?

The low frequency with which this syndrome is given is palpable in the few investigations that there is about a good treatment to alleviate its symptoms or that finishes definitively with these hallucinations.

Gordon Millichap states that the recommended treatment to alleviate the symptoms of the Capgras Syndrome are the Antipsychotic medications and the Cognitive-behavioral or cognitive-behavioral therapy.

In relation to antipsychotic drugs, several studies have been carried out to find out which chemical is most effective in treating this delirium.

A study Of 1983 by Wilcox and Walziri published in The Journal of Clinical Psychiatry presents the case of a young woman, 22 years old, who suffers from this disorder and who is treated with different drugs. In the first place, it is administered trifluoperazine and lithium, that manage to relieve the symptoms to the two weeks of having initiated the dose. However at 6 months, symptoms that are eliminated with haloperidol reappear.

In 1992, Tueth and Cheong presented Journal of Geriatric Psychiatry and Neurology, other case Of a man of 67 years, who does not effect haloperidol, but does respond to the Pimozoid.

As noted by these studies, the efficacy of the drugs to end the delusions is not clear or whether all people react equal to those drugs.

Therefore, Capgras Syndrome, like most diseases that affect the mind must be combined with therapy. In this case cognitive-behavioral therapy.

This treatment is used in other disorders such as depression and tries to address the problem by focusing on behavior modification by patients. Through the therapy sessions, you are trying to give the person suffering from the syndrome the tools to get out of that situation.

Curiosities and other questions about Capgras Syndrome

Can people with this disorder become dangerous to others?

Living with a person suffering from Capgras Syndrome is practically impossible, because if you are the supposed impostor, the affected person will believe at all times that you are lying to him and that you want to do him an evil of some kind. Therefore, they will remain on the defensive.

According to one Article Of the website Psychcentral there have been cases, although few and not very reliable, of people who suffered the delirium of sosias and that suddenly, they have become violent arriving to cause physical damage to people of its surroundings or even the death.

Silva, Leong, Weinstock and Boyer collect in a Article A series of cases of people suffering from the Capgras Syndrome, whose delusions have led him to perform acts with tragic consequences.

Capgras Syndrome in Fiction

The thematic of the doubles has been very recurrent in the Literature and in the culture of our civilization throughout History. According to Robert Berson in a 1986 article I quoted earlier, the use of these characters in fiction to understand the Capgras Syndrome is fundamental.

Here is a list of books and movies dealing with the topic of Capgras Syndrome or the double evil in fiction, in case you want to find out more information about this disorder in a fun and entertaining way.

Recommended Books

  • Richard Powers (2006). The Echo Maker .

Mark Schluter suffers a serious accident that leaves him in a coma. Upon awakening he discovers that his older sister has been replaced by an imposter identical to her.

  • Jack Finney (1955). The Body Snatchers.

A California city is invaded by seeds that are replacing people with doubles.

  • Rivka Galchen (2008). Atmospheric disturbances .

It tells the story of the psychiatrist Leo Liebenstein and how one day his wife disappears and is replaced by an impostor.

Films

  • The Double (2013).

Directed by Richard Ayoade . It is an adaptation of Dostoevsky's novel about a bureaucrat who begins to lose his head when he appears a double identical to him who seems to want to supplant him in his work.

  • The thing (1982).

Directed by John Carpenter . An expedition of investigators in Antarctica discovers a strange being that undergoes a metamorphosis, generating the mistrust and the paranoia between the members of the expeditionary equipment. Based on the short fiction novel by John W. Campbell , Who walks there?

  • The Broken (2008)

Movie directed by Sean Ellis, in which the protagonists characters are replaced by doubles, making that family and friends do not recognize each other.

Series

  • Chapter 13 of season 8.

Appears a person who suffers from Capgras Syndrome and does not want to be treated by his doctor because he thinks he is a stranger.

  • Criminal minds. Chapter 3 of Season 7.

An ex-marine suffers a traffic accident that causes him the delirium of sosias and as a consequence, kills his parents when not recognizing them like so.

  • Mind in Shock.

The plot of this series revolves around Doctor Leon Robles, the protagonist, who looks for his sister, Lola Robles. She suffers from Capgras Syndrome and believes that her brother, the doctor, has been replaced by a double.

* Source of selection of fictions: Wikipedia.

References

  1. Berson, Robert J.,"Capgras' Syndrome"(1982). CUNY Academic Works. Retrieved on February 12, 2017 from: academicworks.cuny.edu.
  2. Dohn, H. & Crews, E. (1986). Capgras syndrome: a literature review and case series. The Hillside Journal of Clinical Psychiatry , 8, 56-74. 2017, February 12, De PubMed Database.
  3. Ellis, H.D., & Lewis, M.B. (2001). Capgras delusion: a window on face recognition. Trends in Cognitive Sciences , 5 (4), 149-156. Doi: 10.1016 / s1364-6613 (00) 01620-x
  4. Feinberg, T. & Roane, D... (2005). False Delusional Recognition. Psychiatric Clinics of North America , 28, 665-683.
  5. Gordon, J. (2013). Neurological Syndromes: A Clinical Guide to Symptoms and Diagnosis . Chicago: Springer Science & Business Media.
  6. Josephs, K.A. (2007). Capgras Syndrome and Its Relationship to Neurodegenerative Disease. Archives of Neurology , 64 (12), 1762. doi: 10.1001 / archneur.64.12.1762.
  7. Silva, J., Leong, G., Weinstock, R. & Boyer, C. (1989). Capgras Syndrome and Dangerousness. The Bulletin of the American Academy of Psychiatry and the Law , 17, 5-14.
  8. Stewart, J.T. (2004). Capgras Syndrome Related to Diazepam Treatment. Southern Medical Journal , 97 (1), 65-66. Doi: 10.1097 / 01.smj.0000104841.61912.79.
  9. Tueth, M. J., & Cheong, J.A. (1992). Successful Treatment With Pimozide of Capgras Syndrome in an Elderly Male. Journal of Geriatric Psychiatry and Neurology , 5 (4), 217-219. Doi: 10.1177 / 002383099200500406.
  10. Wilcox, J. & Waziri, R. (1983). The Capgras symptom and non-dominant cerebral dysfunction. The Journal of Clinical Psychiatry , 44 (2), 70-72.


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