Capgras syndrome: symptoms, causes and treatment
This is this psychotic syndrome based on failures in the recognition of people.
There are disorders that, by their nature or rarity, are little known to ordinary people. One of them is the Capgras Syndromewhich we will define and study today.
What is Capgras Syndrome
The person suffering from Capgras Syndrome suffers from a delusional ideationthat their loved ones have been replaced by impostors replaced by impostor doubles who impersonate them.. It is not exactly that they have difficulties in recognizing faces, as occurs in prosopagnosia, since patients with Capgras Syndrome recognize the facial features that technically define people and therefore have no problems in visualizing faces. However, they interpret the presence of certain people in a delusional manner, believing that they are impostors with a perfect disguise.
From one day to the next, patients with Capgras Syndrome claim that some of their loved ones (usually a partner, a close relative, or even co-workers) have been replaced by identical doubles who behave in the same way, although they present certain different aspects.
At this moment, the emotional bond that existed between them is broken and thus fear, rejection and avoidance appear. They are not able to know why, what for and who has replaced their loved one, but even if this idea makes no sense, they take it for granted that it is true, and will interpret all kinds of facts and actions in the same way. interpret all kinds of facts and actions as signs that they are surrounded by impostors..
Ultimately, patients can recognize the faces of others but do not connect them with emotional meaning. they possess, so that they feel that there is one person with the same face and features as another and at the same time they cannot point to a concrete and coherent reason why that individual is not who he or she claims to be.
History of this rare syndrome
In 1923, the psychiatrist Jean Marie Joseph Capgras first described this syndrome under the name of "illusion of doubles" or "l'illusion des sosies": the patient was a 50-year-old woman suffering from delusions. On the one hand, she thought that she belonged to royalty and, on the other hand, that people around her had been replaced by doubles, since there was a secret society that was in charge of kidnapping people and the appearance of their doubles.
The disorder arose as a result of not overcoming the death of her son, who was only a few months old, and it was then that she began to claim that he had been abducted and replaced. After this, she gave birth again to two sets of twins, of which only one girl survived. After this, her idea of the existence of the kidnapping and substitution network became stronger, and she came to believe that she herself had a double on the outside while she was hospitalized.
Causes of Capgras Syndrome
The exact causes of this syndrome are not known, but the most accepted theory is that it is unknown. the most accepted theory is the disconnection between the visual recognition system and the limbic system, responsible for emotional processing.which is in charge of emotional processing.
The visual system processes stimuli through two distinct pathways: on the one hand, the ventral pathway connects the visual cortex with structures responsible for object recognition and, on the other hand, the dorsal pathway connects the visual cortex with limbic structures, which provide emotional and affective meaning. Therefore, it could be stated that there is a disconnection in the dorsal pathway, since the patient recognizes the relative visually, but does not associate any emotion with him/her.
Comorbidity with other disorders
This syndrome is associated with other psychotic disorders, such as paranoid schizophrenia, psychotic depression, or other delusional disorders. or other delusional disorders. It can also appear together with other diseases, whether brain tumors, cranioencephalic lesions and dementias, such as Alzheimer's or Parkinson's, since neurological alterations of this type rarely affect only a very delimited type of brain function.
Because Capgras syndrome is rare, there are not many studies on validated and effective treatments for Capgras syndrome.. The most widely used and useful medium-term treatment is composed of a combination of psychotropic drugs and cognitive-behavioral therapy.
As for psychotropic drugs, the following types can be used:
- AntipsychoticsAntipsychotics, which are used to combat the delusional idea present in the individual.
- Anticonvulsantswhich are used as support if necessary.
- Other drugs according to the pathology present.
2. Psychological therapy
If we focus on psychological therapy, it will be used, mainly, the cognitive restructuring. By means of this technique, the patient will be confronted with his delusional and incoherent idea, making him see that it is his emotional perception that has changed, and that the others have not been replaced. In addition, he will be taught to undertake strategies to compensate for these failures of recognition in other ways, and to deal with the anxiety that these errors may provoke..
An intervention with the family would also be desirable, due to the emotional toll that the disease takes on both the patient and the family members.
Capgras Syndrome syndrome has caused family relationships to deteriorate, resulting in estrangement among family members.This distancing is not advisable if we want the family to cooperate in the recovery process. To this end, it is necessary to make sure that they understand the situation and that everything is due to a neurological alteration, and not to the patient's decision making.
Finally, it must be taken into account whether the patient has a primary pathology from which this syndrome has developed. If so, such pathology would prevail when choosing a treatment and applying it.
- Aziz, V.M. and Warner, N.J. (2005). "Capgras' Syndrome of Time." Psychopathology. 38(1): pp. 49 - 52.
- Bhatia, M.S (1990). "Capgras syndrome in a patient with migraine". British Journal of Psychiatry. 157(6): 917 - 918.
- Ellis, H.D. and Young, A.W. (1990). "Accounting for delusional misidentifications". The British Journal of Psychiatry. 157(2): 239 - 248.
(Updated at Mar 28 / 2023)