Capgras syndrome: Analysis of nine cases

Three hundred and sixty-four patients, 158 males and 206 females, were admitted to an acute psychiatric ward between November 1994 and October 1995, and only 9 patients (2 males and 7 females) fulfilled the clinical criteria for Capgras syndrome. The crude prevalence of Capgras syndrome in the acute psychiatric ward was 2.5% (1.3% for men and 3.4% for women), which is not uncommon. Medical records and laboratory examinations, including brain images and electroencephalographic examinations (EEG), were reviewed in the nine patients with Capgras syndrome. Four cases were proven to have apparently abnormal anatomical lesions on EEG, brain computed tomography, magnetic resonance imaging or single photon emission computed tomography (99mTc-HMPAO) examinations and five cases were associated with major physical illness. These findings support that organic factors could be important in the pathogenesis of Capgras syndrome.     

Delusional misidentification secondary to perceptual abnormality: An unusual case of Capgras syndrome

Capgras syndrome is the commonest of the delusional misidentification syndromes, occurring in 1 &#45 5% of psychotic patients. This case of a Capgras syndrome was secondary to an abnormal percept (auditory hallucination). Capgras syndrome is not a symptom specific to abnormalities of face recognition. ( Int J Psych Clin Pract 2000; 4: )     

A case of the Capgras syndrome in association with pseudo-hypoparathyroidism

Two brief episodes of psychosis in a patient with pseudo-hypoparathyroid syndrome are described. The psychotic phenomena occurred in clear consciousness and were schizophrenia-like and included the Capgras symptom. Both episodes followed a course of electro-convulsive treatment given for depressive symptoms, and electroencephalograph recordings showed evidence of reduced stability. The content of these psychotic episodes, especially the Capgras symptom, was understandable in view of the patient's restricted social situation. It is suggested that the effect of electro-convulsive treatment acting on a previously abnormal central nervous system, was sufficient to produce these schizophrenia-like psychosyndromes.     

A Rare Case of Capgras Syndrome Observed in Wake-Amine Induced Psychosis

Abstract: An adolescent girl showed the apparent Capgras syndrome in the course of wake-amine induced psychosis. The patient, then 18, committed homicide in close connection with the syndrome and also with the distorted judgment due to personality immaturity. As far as the syndrome was concerned, the extension was so extreme that it involved her neighbors and even her dwelling city. The detailed case history was reported along with a discussion about the psychodynamism.     

Diogenes syndrome in a patient with obsessive-compulsive disorder without hoarding

Diogenes syndrome (DS) is characterized by self-neglect, classically portrayed by a filthy personal appearance, dirty home, and hoarding of rubbish. We report a patient with DS who presented obsessive–compulsive disorder and Tourette syndrome in the absence of hoarding. We suggest that hoarding may be a symptom of the conditions that are frequently comorbid with DS, but is not one of its fundamental features.     

Diogenes syndrome in patients suffering from dementia

Diogenes syndrome (DS) is a behavioral disorder of the elderly. Symptoms include living in extreme squalor, a neglected physical state, and unhygienic conditions. This is accompanied by a self-imposed isolation, the refusal of external help, and a tendency to accumulate unusual objects. To explore the phenomenon of DS in dementia we searched for the terms: “Diogenes syndrome, self-neglect, dementia. ” It has long been understood that individuals with dementia often become shut-ins, living in squalor, in the Eastern Baltimore study, dementia was present in 15% of the elderly cases with moderate and severe social breakdown syndrome; twice as many as in the general population of the same age group. Researchers have underlined the frequent presence of DS (36%) in frontotemporal dementia (FTD): different neuropsychological modifications in FTD may contribute to symptoms of DS. The initial treatment should be a behavioral program, but there is not sufficient information regarding pharmacological treatment of the syndrome.     

Capgras delusion in the elderly: The evidence for a possible organic origin

We report the case of a 77-year-old right-handed woman with early dementia of the Alzheimer type who developed the paranoid delusion that her husband had been replaced by an imposter (Capgras phenomenon). Her CT scan showed mild generalized cortical atrophy of the parieto-occipital cortex. We reviewed the cases of 45 patients over 60 years who showed a Capgras delusion. Twenty-five suffered from dementia or other chronic organic mental disorders, 20 were paranoid, 14 were at least moderatley depressed and 12 disorientated. CT scans (reported in 17 cases) showed global cerebral atrophy in 12 patients. Right hemisphere infarcts have been described in two elderly patients with Capgras delusions. Focal brain atrophy in Alzheimer type dementia has hitherto not been reported in association with this delusional symptom. We conclude from these observations that marked cerebral lesions and specific neuropsychological deficits are not required for the development of the Capgras phenomenon, which can occur in various functional or organic psychosis of old age.     

An odd manifestation of the Capgras syndrome: Loss of familiarity even with the sexual partner

We report the case of a patient who presented visual hallucinations and identification disorders associated with a Capgras syndrome. During the Capgras periods, there was not only a misidentification of his wife's face, but also a more global perceptive and emotional sexual identification disorder. Thus, he had sexual intercourse with his wife's "double" without having the slightest recollection feeling of familiarity towards his "wife" and even changed his sexual habits. To the best of our knowledge, he is the only neurological patient who made his wife a mistress. Starting from this global familiarity loss, we discuss the mechanism of Capgras delusion with reference to the role of the implicit system of face recognition. Such behavior of familiarity loss not only with face but also with all intimacy aspects argues for a specific disconnection between the ventral visual pathway of face identification and the limbic system involved in emotional and episodic memory contents.     

Homo-erotomania for a delusional parent: erotomania with Capgras and Fregoli syndromes in a young male with learning difficulties

A 19-year-old male with learning difficulties exhibited erotomania associated with first-rank symptoms of schizophrenia; the subject responded to neuroleptic medication. The love object was a male neighbour believed by the subject to be his father. This is the first recorded case where erotic desire has been coupled with the delusion that the object is also the parent of the sufferer. We propose a multifactorial aetiology, considering the possibility of complex psychodynamics in the presence of learning difficulties.