Written by Kerem Muldur
After a long trip abroad, you are very happy to be reunited with your home, spouse, and children that you missed so much. But when you came home, your spouse started to claim that she did not know that her spouse was not you, and that you were faking it. What a helpless moment it is! In this case, the disease that leaves you helpless is most probably the Capgras syndrome. Simply, in this syndrome, people often believe that a double or imposter has replaced their loved one or close one. This syndrome was described by Joseph Capgras, a French psychiatrist, in 1923 and was classified as DMS (delusional misidentification syndrome) (1). Also, in 1991 Christodolou considered Capgras syndrome to be one of four syndromes known as delusional misidentification syndromes. These are Capgras, Fregoli, Intermetamorphosis, and Subjective Doubles Syndrome. Capgras syndrome is a very rare delusional misidentification syndrome, The incidence rate of the syndrome is 0.12 percent while the psychiatric population rises to 1.3 percent. It is more likely to occur in women than men (2).
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The Relationship between Capgras Syndrome and Other Diseases
Capgras Syndrome does not usually occur alone. It usually occurs in patients with underlying conditions such as schizophrenia, dementia, or Alzheimer's. Research into the causes of this syndrome has found similarities with the disorder called Prosopagnosia. The other name of this disorder is “Face Blindness.” People with this disorder cannot recognize the faces of their acquaintances, spouses, or even their own faces as a result of a type of brain damage. However, according to a study conducted in 2019, The fact that you don't know someone doesn't mean you'll label them as an imposter.
Causes of Capgras Syndrome:
The causes of Capgras syndrome are a little unclear and open to discussion. However, Caprgas Syndrome is mainly caused by damage to the brain, especially damage to the temporal lobe and bifrontal lobe. The theory put forward by scientists according to their latest studies revealed that this syndrome has a close relationship with Alzheimer's, schizophrenia, and some other dementias. So much so that it was revealed that 32 percent of 255 Capgras syndrome cases examined in 2019 also had schizophrenia, 15 percent had some form of dementia, and 6 percent had schizoactive disorder (3). When the cause of this disease is examined in the brain, the belief is that the cause of this syndrome is due to the disconnection and miscommunication between the extended nervous system, which emotionally scans the face when we see a familiar face, and the central nervous system, which scans the features of the face.
Treatments of Capgras Syndrome:
Unfortunately, there is no cure for Capgras syndrome. However, since Capgras syndrome is often associated with other diseases such as schizophrenia, treating these diseases may be a solution to Capgras syndrome. In addition, certain therapies can be applied depending on the condition of these patients. For example, with habilitation therapy, loved ones try to put themselves in the patient's place to better understand what they are feeling. Validation therapy gives the patient a sense of safety if they are scared that the imposter is there to hurt them. And do not tell Capgras patients that they are wrong. This may give them an adverse reaction. Instead, try distracting them with something else (4).
Conclusion
In conclusion, Capgras syndrome is a rare and interesting type of delusional misidentification in which the patient thinks that people with whom he is in a close relationship have been replaced by an imposter. This syndrome often occurs with diseases such as schizophrenia. The reason for this syndrome is not that the patient cannot physically recognize their relatives, but that they express that the devil has escaped inside them, so to speak because they cannot feel the old sincerity and warmth in the person they know. Although there is no specific treatment for these patients, certain therapies may be helpful.
References:
Sadgun Bhandari. (2012). Core Psychiatry (Third Edition). sciencedirect.com. https://www.sciencedirect.com/topics/neuroscience/capgras-delusion
Capgras syndrome due to cannabinoids use: A case report with radiological findings. (2022, January 19). The Cureus Journal of Medical Science: Peer-Reviewed, Open Access. https://www.cureus.com/articles/83724-capgras-syndrome-due-to-cannabinoids-use-a-case-report-with-radiological-findings#!/
Capgras’ delusion: A systematic review of 255 published cases. (2019, July 19). Karger Publishers. https://doi.org/10.1159/000500474
Davis, J. (2020, January 10). What is impostor Capgras syndrome? WebMD. https://www.webmd.com/mental-health/impostor-syndrome-capgras
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