Capgras Syndrome- Definition, Causes, and Treatment

Definition

Capgras syndrome is a psychological condition that is characterized by a belief that a particular person has been replaced by an imposter. This bizarre belief may lead one to acrimoniously accuse a friend or spouse of being “a fake” or an “imposter” of the actual person.

As you can imagine, capgras syndrome causes great discord and anxiety in the lives of not only the person suffering from it but also from the person being accused as well. This syndrome is sometimes called the “imposter syndrome” or “capgras delusion”.

There is really no limit to what someone with this syndrome will accuse as being an impostor. In fact, according to the health line, in some specific cases, someone who is experiencing capgras syndrome may actually believe that an inanimate object, an animal, or even a home is an imposter. It has been shown that this syndrome can affect anyone. However, it’s more common in women, and in rare cases, it can affect children also.

History

It is named after Joseph Capgras (1873-1950), a France|French psychiatrist who first described the disorder in a 1923 paper by Capgras and Reboul-Lachaux. They used the term  l’illusion des sosies (the illusion of doubles) to describe the case of a French woman who complained that various “doubles” had taken the place of people she knew. However, the term illusion has a subtly different meaning from delusion in psychiatry so “the Capgras delusion” is used as a more suitable name.

Epidemiology

Though more common in women than in men, this syndrome is most definitely possible in anyone and has even been known to affect children in some rare cases. Overall, however, the disorder is considered to be quite rare with approximately 1.3% of people suffering from it in any given year. In the general population, approximately 1.8% of females and 0.9% of males are believed to have the disorder, whether diagnosed or undiagnosed. Unfortunately, it’s a disorder with very poor treatment results and outcomes.

Causes

  • The exact cause of Capgras syndrome is not known, but there are a number of theories. Some researchers believe it is caused by problems within the brain such as atrophy, lesions, or cerebral dysfunction. Some others believe that it’s a combination of physical and cognitive changes.
  • However, it is commonly associated with Alzheimer’s disease or dementia, affecting memory and the sense of reality. Episodes of Capgras syndrome can also be experienced by people with schizophrenia.
  • In rare cases, the syndrome can also be caused due to a brain injury especially in the back of the right hemisphere of the brains that processes facial recognition. Also, people with epilepsy may experience the syndrome in rare cases.

Symptoms

  • Though Capgrass Syndrome has been linked to several different physiological disorders it has been seen most commonly in people who have Paranoid Schizophrenia or in individuals who have Dementia.
  • Those who have Capgras Syndrome are found to be in a delusional, almost neurotic state and are typically non-responsive to any caregiver.
  • They also tend to be very hyper active and very anxious, which can cause a great amount of stress on both the afflicted and those around them, as stated by PhychCentral.
  • Individuals that have Body Dementia are the ones who are most often the ones who develop this condition, Body Dementia is a common form of dementia that shares characteristics with both Alzheimer’s and Parkinson’s diseases.
  • Since Lewy Body Dementia (LBD) symptoms resemble other diseases, it can be especially challenging to diagnose correctly.

Diagnosis 

Because it is a rare and poorly understood condition, there is no definitive way to diagnose the Capgras delusion. Diagnosis is primarily made on the psychological evaluation of the patient, who is most likely brought to a psychologist’s attention by a family member or friend believed to be an imposter by the person under the delusion.

Treatment and medications

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 general tips for caring for someone with Capgras syndrome include:

  • Being patient and sympathizing, as Capgras syndrome can cause real fear and anxiety.
  • Limiting exposure to the “imposter” when an episode is taking place.
  • Having the “imposter” speak before they are seen, as their voice may be recognized.
  • Acknowledging the feelings surrounding the identity confusion when they occur.
  • Not arguing with the person about the “imposter” they think they are seeing.

How to Take Care of Someone Who Has Capgras Syndrome

A caregiver who has to deal with a patient with Capgras Syndrome may feel frustrated, especially if they are the ones who are viewed as the impostor.  Aging Care gives some tips to be able to assist the individual who is suffering from it. These are ways in which a person can help a Capgras Syndrome patient:

Accept their feelings and concerns.

Instead of negating their view, the caregiver should show that they understand what the patient is feeling and that it is all right for them to feel that way. Instead of correcting their perception of reality, they should try to picture themselves in the same situation.

Create a secure and emotional attachment.

The caregiver should also remind them how much they and the ‘impostor” loves them. If the person suffering from Capgras Syndrome has the belief that the “impostor” is trying to hurt them or steal from them, they should be constantly reassured that the said “impostor” would not do those things.

Depend on sound interactions.

It is revealed that patients with Capgras Syndrome have a hard time visually connecting to their loved ones. A better alternative to having face-to-face visits with the patient is talking to them by telephone. The person who wishes to interact with the patient may also talk to the patient personally, as long as they are out of the patient’s line of sight. The person identified as an impostor can announce their arrival before the patient is able to see them. Doing this will aid in making an emotional bond and starting a conversation as the visitor appears gradually within their vision. This can also help the patient positively recognize their loved one.

Here are some more tips for caregivers

  • Acknowledge their feelings: Say things like “I know this is upsetting and am sorry this is happening to you.”
  • Stay emotionally connected: Say things like “I care about you and you are safe here.”
  • Send the imposter away: Once the “imposter” has left the room, continue to reiterate that you have sent them away and your loved one is safe. Keep engaging warmly and emotionally.
  • Connect through sound: The “imposter” can say things right outside the door, out of sight, like: “Hi honey, I’m home. What smells so great? I can’t wait to have dinner with you,” etc. This ensures a positive identification of the “real” person via an emotional connection.
  • Don’t argue and prove the person wrong. Accept that the person afflicted by this syndrome absolutely believes their spouse, friend or other caregiver is an imposter. Trying to prove them wrong is like trying to convince them the sky is not blue.
  • Your hospice care provider can work with you as the family member on a daily basis in reinforcing these approaches.

Prognosis

  • 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.
  • Anyone experiencing or witnessing the symptoms of Capgras syndrome should speak to a doctor as soon as possible.

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