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Capgras syndrome

If one day your partner/loved one, comes up to you and says they do not recognise you anymore or they need to find the ‘real’ you, what would you do? Capgras syndrome is a psychological condition, characterized by delusional (unrealistic) belief that their partner or a person they are close to has been replaced by visually similar imposter or a replica. It is also known as “imposter syndrome”. Their belief is deeply rooted and real that nothing can correct this belief. In few cases, the person expecting the delusion may believe an animal, object or even a home is an imposter. For example, accuse a spouse of being an imposter of their actual spouse.

Capgras Syndrome was named after Joseph Capgras who was a French Psychologist who described the first case with the help of a colleague in 1923. It was about, Madame M who had delusions that her husband was exchanged for a double. Later on it was reported that, she had complex mental illness with various symptoms in addition to the delusion of substitution. Capgras syndrome seemed to have a pattern of occurrence. It has been repeatedly reported in late stage Alzheimer dementia but it can also occur without dementia. Capgras syndrome can develop after an injury in the right hemisphere. Capgras syndrome is one of the several syndrome classified under ‘Delusional Misidentification Syndromes (DMSs)’.

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Causes/Risk factors-

- Schizophrenia- especially paranoid hallucinatory schizophrenia
- Dementia/ Alzheimer
- Epilepsy is to believed to be co-occurring condition
- Cerebral injury
- Few researchers believe that, it is combination of physical and cognitive changes.
- Disconnection between visualization and facial recognition.
- Hyperthyroidism/ hormonal imbalances
  

Symptoms

- Most obvious symptom is when someone starts to believe their partner/closed one is either double or replaced by someone else.
- Language deterioration
- Restlessness
- Obsession over personal hygiene
- Common side effects include- accusatory statements, violent behaviour, impaired vision, paranoia and long term delusions.  

Treatments

For now, there aren’t many treatment options for people with Capgras syndrome as more research needs to be done. But the available treatment plans relieve the symptoms.

In few cases, Validation therapy can be useful as it focuses on accepting the misidentification which helps the patient to relax and reduces anxiety.

Treatments for underlying conditions includes-

- Antipsychotics and therapies for people with schizophrenia
- Surgeries for brain injuries of head trauma
- Medication to boost neurotransmitters for improving memory and judgment for dementia and Alzheimer’s disease.
- Memory and recognition medications

Caregivers or family members should provide a safe and comfortable space/environment for stress free atmosphere.