Capgras syndrome

Capgras syndrome

The syndrome of Capgras, also known as 'illusion of doubles ', was first described by Jean Marie Joseph Capgars. It is a disorder, part of a psychotic process, by which the affected person has delusional that belief a close person that there is an emotional bond, usually a family member that lives, has been replaced by another person, a substitute for identical both in his physical form of acting, resulting in strong feelings of fear and rejection of that person to considers it to be an imposter.
Imagine for a moment the situation, you come back from work, and after opening the door of House you meet a stranger, who seems much to familiar (your husband, your son...) with which you share home, but some differences do you think that it is not. The fear and even terror that may cause this situation will generate a great psychological suffering who suffers.
He why has been replaced, by whom, or what are questions is not able to explain is the person who suffers from Capgras syndrome, which adds even more uncertainty and fear of the situation. This is going to result in feelings of avoidance or rejection for the substitute, this being the first symptom that can appreciate a close above that something is wrong. A situation that if not resolved will generate a great family tension, which may end up with the separation of the couple, as they are this is the replaced, or distance from your loved ones.
Now get in the contrary case, your wife, good at first, says you're not whom he married, you're a stranger, and you don't want to share the House with you, insist that you leave your life, since you are a complete stranger, and do not know of your intentions for it. How would you feel? For thus is how the substitutefeels: surprise, surprise and incomprehension, you know that there is a problem, and that it is serious, but does not know how to fix it, because for many explanations that try to give, or attempt to provide evidence that you are who say to be, always, the person who suffers from this syndrome does not seem to want to understand that nothing has changed.

Causes of Capgras syndrome

The illusion of doubles is more common in women, and might be temporarily or chronically, and can occur at any time of life. Currently there is no consensus on the explanation on the origin and maintenance of Capgras syndrome, considering this multifactorial. Yes it has been observed is often appearing together with organic such as head injury or brain tumor disorders, as well as with psychological disorders like paranoid schizophrenia, psychotic depression or delusional disorders.
Also, in several studies with affected by Capgras found how it affects different regions of the brain involved in processing visual and emotional, as well as the recognition of faces. In addition, this syndrome has been observed in between 6 and 30% of the cases of patients with Alzheimer's disease, and one smaller percentage, in other types of dementia or Lewy body Parkinson's.

Symptoms of Capgras syndrome

Ideation of substituting a double is the symptom most characteristic and defining Capgras syndrome, whereby the person has a firm conviction that a next person, that there is a strong emotional bond, has been replaced by an impostor who is identical in all aspects, but despite this, who is suffering appreciate subtle individual differences original.
By family and friends, the most obvious symptoms of the disease is the rejection or avoidance of a family member, that there is a close emotional bond. In fact, some authors define this disorder as a loss of emotional recognition, i.e., referred to who is ahead, he is seen, are reminded, but the emotional ties that bound them were forgotten, now considering him as a stranger.
This will trigger a series of family changes, as it may be that the person who suffers from Capgras syndrome isn't willing to stay under the same roof that someone who is now considered as an unknown, which in many cases leads to divorces and separations, where replaced is the couple.
In addition to these demonstrations, Capgras Syndrome will be accompanied by other symptoms:
  • Delusional conviction: i.e. by many tests that attempt to give the family about its authenticity, the affected by Capgras will continue to think the same. Of course there are these differences, since the husband, wife or child are the same, but despite this, who suffers from Capgras syndrome remains with his erroneous belief that your family member has been replaced by another person.
  • Serious family or couple issues associated with rejection and the conduct of avoidance by sufferer syndrome to double, since it becomes impossible coexistence under the same roof because of the fear that causes affected this entire situation.
  • Normally with the rest of the people: this delusional perception is not extended to other subjects that not holding an emotional bond, and even will affect all the relatives, only to one of them, behaving and interacting with everyone else naturally, except with the imposter.
  • This disorder can be accompanied by paranoid ideas, that the deranged thinks that the substitute wants to harm him, ideas that moreover help to respond to the person suffering the syndrome by what has been replaced the family and for what.
  • They believe that any person has been changed, while externally its appearance is the same and that you speak and behave in the same way, unlike the prosopagnosia, a problem in which the affected person suffers an alteration in the perception of the human faces, being unable to distinguish between faces of familiar people facing the strangersand can identify family members by other features such as voice or clothes carrying.

Diagnosis of the syndrome of Capgras

One of the first challenges for the family that suffers from this situation, either substitute or not, is know to turn, since you can't find a way to reason your loved one, so sometimes causing some delay in the diagnosis of the syndrome of Capgras, to reach which will be necessary to go to various professionals.
In these cases the neurologist is the most suitable professional to detect and diagnose this disorder, as well as to establish the most appropriate treatment for each patient.
The truth is that it will be complicated to the person suffering the syndrome, convinced that nothing you, want to collaborate and go to consultation, so the family will need to use the full capacity of persuasion to get that you lend to different neurological tests and neuropsychological required to determine the diagnosis:
  • Test of verbal fluency, phonological and semantic, for assessing the language, since there has been a reduction in verbal fluency in these patients.
  • Verbal test to check the memory status, since changes in this capacity in patients with this syndrome have been.
  • Test of face recognition and task of recognition of faces (relatives and non-relatives), which serves to rule out other pathologies such as the prosopagnosia.
  • Test of cubes, the TEst of WAIS, to measure the capacity of visuospatial/visoconstructiva.
  • Test multi-tasking to corroborate the executive functions, that depends a lot on the frontal lobes.
Equally, and complementing the above, recommended testing of neuroimaging functional MRI, with which to observe if there is any malformation in the brain that may explain the symptoms of the patient or the TAC. The Assembly of the results of these tests will provide valuable information to the neurologist to understand what capabilities are affected, and thus to determine the proper diagnosis, as well as the severity of the same.

Differential diagnosis of the syndrome of Capgras

However, the most important thing to get to the correct diagnosis of Capgras syndrome, once verified the presence of the symptoms described here and in the previous section, is the differential diagnosis of other diseases that can have symptoms and similar pictures and which should be ruled out beforehand, as in the case of:
  • Fregoli syndrome: in this disorder the person thinks that anyone, even a stranger, is a close relative. So it is unable to distinguish between relatives and strangers, whereas everyone as if they were his own family, though it stops them know. Therefore it shows symptoms contrary to the syndrome of Capgras, who often reject the double.
  • Subjective twice: the person who suffers it believes that there is a double, but in this case instead of being a family, is itself, and which acts independently to his will.
  • The intermetamorfosis: the person suffering it thinks that others have exchanged their identities, being now his mother in the body of the postman, and this in the body of the goalie, and so on, not reaching to be nobody "on your website".
Once known the diagnosis of Capgras syndrome, and always with the collaboration of the patient who suffers from this disorder, establishing treatment aimed both to improve the symptoms and they disappear, as to save the situation of family breakdown which accompanies this syndrome in many cases.

Treatment of the syndrome of Capgras

Currently unknown causes originating the Capgras syndrome, because what can not talk about a treatment which cures this disorder, but basically this is to try to control their symptoms, using for this purpose, mainly, psychoactive drugs:
  • Antipsychotics are used to fight the conviction of the sick, which keeps the mistaken belief that his family is another, a double, even despite evidence that may arise, as well as the paranoid ideas where they exist.
  • Anticonvulsants are often used also as supportive treatment, when so the neurologist considers this.
Once controlled psychotic symptoms, it usually indicates start psychological treatment to help the person to integrate into your life to those double, in such a way that it does not reject them, allowing you to take a slightly more normal life as much as possible.
This psychological therapy consists in carrying out a technique of cognitive reconstruction, where he confronts the patient to the irrationality of their delusional beliefs, trying to demonstrate the reasons why have those feelings, make him understand that it has been he who changed his emotional perception concerning the person replaced.
At the same time, and because of the great emotional pressure, suffered as a result of this syndrome, both for who suffers for the rest of the family, is usually also recommend family therapy, in order to improve these relationships and that family members do not become an obstacle to recovery, but an aid to the patient.
In addition, should keep in mind that when the affected by the syndrome of Capgras presented other disorders such as Alzheimer's or other dementias, as Lewy bodies or Parkinson's, paramount will prioritize the treatment of these pathologies, due to the severity of their advance in deterioration of cognitive and motor functions of the person who suffers from them.

Tips for family members affected by Capgras syndrome

Currently it is unknown the origin of Capgras syndrome, so it is not possible to determine a preventive medicine that helps prevent blisters, but what we can do is to work to reduce their effects disruptors in family life when it appears, such as separations or divorces. It is for this reason that this disorder is of vital importance for the attitude of the closest relatives of the affected, both in the arrest of the first symptoms of the syndrome and its role in support of the treatment to your loved followed.
Here are some guidelines and Tips for family members of patients with Capgras syndrome:
If suddenly you notice a rare attitude of a close relative, especially if it avoids physical contact with someone dear, ask what happens, since the rejection is one of the first symptoms of this syndrome.
If you have changed, or not be the same individual, do not try to show him that he is wrong, better seek help from a neurologist, who determine what is what happens, and can confirm if you suffer from this or another similar syndrome.
Once you have the diagnosis of Capgras syndrome, if you're the person that mistaken an impostor and you refuses or avoids, tries to understand that this is part of the disease that suffers, and is not responsible for their feelings. It tries to be sympathetic with the situation while it may be painful.
If your family member has Alzheimer's, he thinks that even in a third of cases Capgras syndrome may appear in those affected by this disease, so it is convenient to be prepared to understand the changes that the patient may suffer with regard to their emotional world where relatives are concerned.
To produce these changes of emotion to one of the members of the family, should explain what is happening to the rest of the local environment, especially to children, so that they understand the situation and that does not mean that parents take wrong or already not be wanting, if that is not the product of a disease to be treated.
Article contributed for educational purposes
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