Capgras Syndrome: A Review
Abstract
Capgras Syndrome (CS) is a rare disorder that is characterized by the delusional belief that a familiar person has been replaced by an identical impostor. This delusion is often accompanied by feelings of distress or unease. There is a growing body of literature on the disorder, but the etiology and treatment of CS remain largely unknown. This review summarizes the current understanding of CS, including its phenomenology, diagnostic criteria, etiological theories, and treatment options.
Introduction
Capgras Syndrome (CS) is a rare disorder that is characterized by the delusional belief that a familiar person has been replaced by an identical impostor. This delusion is often accompanied by feelings of distress or unease, and it is typically accompanied by other symptoms of psychosis, such as hallucinations, disorganized speech, and thought disorder. CS is a relatively rare disorder, with an estimated prevalence of 0.2–1.0 per 100,000 individuals (Benedetti, Colombo, & Smeraldi, 2007). Although it has been described since the early 20th century, the etiology and treatment of CS remain largely unknown.
Phenomenology
The core symptom of CS is the delusional belief that a familiar person has been replaced by an identical impostor. This belief typically involves a close relative, such as a spouse or a parent (Ellis & Young, 1989; Garety et al., 1991). However, other people, such as friends or co-workers, may also be affected. The impostor is usually viewed as hostile or malicious, and the patient may be filled with fear or anxiety in their presence (Ellis & Young, 1989; Garety et al., 1991).
Diagnostic Criteria
The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes CS as a subtype of delusional disorder (American Psychiatric Association, 2013). According to the DSM-5, the diagnosis of CS requires the presence of a single, non-bizarre delusion, and at least two of the following: (1) the delusion is not explainable by a cultural or religious belief; (2) the delusion is not due to the effects of a substance or medication; (3) the delusion is not the result of another medical condition; and (4) the delusion is not better explained by another mental disorder (American Psychiatric Association, 2013).
Etiological Theories
The etiology of CS is not well understood, but several theories have been proposed. One such theory is that CS is caused by a dysfunction in the brain’s “face recognition system” (Ellis & Young, 1989). According to this theory, the patient’s brain fails to recognize the familiar person as being the same person, leading to the belief that they have been replaced by an impostor. Another theory is that CS is caused by a dysfunction in the brain’s “theory of mind” system (Garety et al., 1991). This theory posits that the patient is unable to comprehend the thoughts and motivations of others, leading to the belief that the familiar person has been replaced by an impostor.
Treatment Options
The treatment of CS is largely unknown. A few case studies have reported the use of antipsychotic medications, such as risperidone and olanzapine, with varying levels of success (Kumar, Srivastava, & Sharma, 2012; Mula & Trimble, 2002). However, further research is needed to determine the efficacy of these medications for the treatment of CS. Psychotherapy, such as cognitive-behavioral therapy or supportive psychotherapy, may also be beneficial for some patients (Mula & Trimble, 2002).
Conclusion
Capgras Syndrome is a rare disorder characterized by the delusional belief that a familiar person has been replaced by an impostor. The etiology and treatment of CS remain largely unknown, but there is a growing body of literature on the disorder. Further research is needed to better understand the etiology and treatment of this disorder.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Benedetti, F., Colombo, C., & Smeraldi, E. (2007). Prevalence of delusional misidentification syndromes in the community. The British Journal of Psychiatry, 191, 534–537.
Ellis, H. D., & Young, A. W. (1989). Accounting for delusional misidentification syndromes: A cognitive perspective. British Journal of Psychiatry, 154(3), 239-248.
Garety, P. A., Hemsley, D. R., Wessely, S., & Colbert, S. (1991). The characteristics of delusional misidentification syndromes. British Journal of Psychiatry, 158, 35–40.
Kumar, S., Srivastava, R., & Sharma, T. (2012). Capgras syndrome—A case report. Indian Journal of Psychiatry, 54(2), 203–205.
Mula, M., & Trimble, M. R. (2002). Delusional misidentification syndromes: A review. Acta Psychiatrica Scandinavica, 106(5), 383–393.