Understanding the “Capgras Syndrome”

Capgras syndrome may affect anyone, but it is more common in women.

A person with Capgras syndrome irrationally believes that someone they know has been replaced by an imposter. In some cases, they may also believe pets or even inanimate objects are imposters.

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).

Although this psychological condition can affect anyone, it is more common in women than men. Capgras syndrome can be very disturbing for the person affected, as well as for their loved ones.

Symptoms of Capgras syndrome can be perplexing and frustrating for both the person affected and those around them, and unlike other mental health conditions, which tend to impact many aspects of someone’s life, a person with Capgras syndrome acts normally except around the person or thing they believe is an imposter.

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symptom of Capgras syndrome is when someone starts to believe that a person close to them is either a double or has been replaced by someone else. The person may acknowledge that the “imposter” looks exactly like the “original,” but they believe that they can see through the “disguise.” This can cause anxiety and changes in someone’s behavior.

In some cases, a person may be violent towards the “imposter,” although this is not always the case. It is more likely that the person will appear anxious or afraid. The person affected by Capgras syndrome may become obsessed with the “imposter” or with finding the “real” person. This can lead to additional stress, anger, and arguments between the person affected and those around them.

While the exact cause of Capgras syndrome is unknown, it may result from an injury to the brain. The exact causes of Capgras syndrome are not known, but there are theories about why its symptoms occur. One theory is that Capgras syndrome results from a brain injury involving lesions on the brain. Traumatic lesions on the brain were present in more than one-third of all documented cases of Capgras syndrome looked at in one study.
Capgras syndrome could also be caused by a disconnect between the visual part of the brain and the area that processes facial familiarity. This disconnect could cause a person to misidentify someone they know.

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.

The following are some examples of reported cases of Capgras syndrome:

one case, a man could not recognize his parents when face-to-face with them. However, when speaking to them over the phone, he did recognize them, without issue.
In this case, it is possible that the disorder was caused by a disconnect between visualization and facial recognition. Other recognition methods, such as voice recognition, were not affected.

In another case, a mother believed that her daughter had been removed by Child Protective Services and replaced with an imposter. The mother was diagnosed with Capgras syndrome and prescribed medication but could not be convinced of her daughter’s identity.
Treating underlying conditions with therapy may help to reduce or cure the symptoms of Capgras syndrome.

Currently, there is no standard treatment for people affected by Capgras syndrome, and more research is needed to find the most effective way it can be treated.
In some cases, treating the underlying condition can reduce or cure someone’s symptoms. For example, controlling or treating Alzheimer’s disease may improve the symptoms of Capgras syndrome.

Treatments for underlying conditions vary widely, but may include: antipsychotics, therapy, surgery, 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.

In other cases, caregivers and facilities may actively attempt to ground the person in reality, as far as they can, by giving frequent reminders of the time and place.
Caregivers and family members can also assist by providing a safe and comfortable space free from external stressors, as much as possible.

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.

Source: Jenna Fletcher/Medical News Today

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