Capgras syndrome is a personality disorder in which a person develops and propagates the idea that a loved one or animal has been replaced by a completely different creature in an old guise. Capgras syndrome is often called “delusional syndrome” because a person experiences delusions that involve misrecognizing people or other objects. The disorder can take place in the following forms:
- acute form;
- transitional form;
- chronic form.
Delusional thoughts most often occur in patients diagnosed with paranoid schizophrenia. There are cases when the above manifestations occur due to a head injury. The syndrome is often detected in people with acquired or congenital diseases of the nervous system, especially at an older age.
Medical studies have shown the relationship between the development of this disorder, diabetes mellitus and migraine. According to research, scientists have found that Capgras syndrome affects women about 20 percent more often than men. The information collected during the research gave scientists an understanding of the differences in neuroanatomy between a healthy person and someone suffering from this pathology.
Clinical picture of the disease
To better understand what Capgras syndrome is, we will give several examples in which the clinical picture of the disease is clearly visible.
A 70-year-old married housewife was recently discharged from a local psychiatric hospital. After some time, she again ended up in the same psychiatric hospital for re-examination. A woman was diagnosed with Capgras syndrome - due to her belief that her husband was replaced by a completely different person. Because of this, she refused to sleep with him, locked herself away from him in the bedroom and asked him to give her a weapon to defend herself from the impostor. She also resisted when hospital staff tried to send her to a medical facility. Against the background of her husband's mistaken recognition, she recognized other family members well.
The girl Diana was convinced that there were two completely exact copies of one person in the world. Moreover, the first copy always wanted good, and the other, on the contrary, only evil. Against this background, she was given a psychiatric diagnosis - schizophrenia with Capgras syndrome.
You are a stranger here: why people with Capgras syndrome do not recognize their loved ones and themselves
Photo: Nikolay Kostyushin, MTRK "Mir"
We are talking about a rare and unusual mental disorder - Capgras syndrome, or the “illusion of doubles”.
Imagine that one morning you woke up and stopped recognizing your loved ones. The environment seems unfamiliar to you, and the family members seem like complete strangers who also want to harm you. It sounds crazy and scary, but there are people in the world who experience these emotions every day. Some, on the contrary, suddenly begin to recognize strangers as friends and relatives, and some even believe in the existence of their own double. All these unfortunate people have one thing in common - they suffer from Capgras syndrome. Read about what this rare disorder is and whether it can be cured in the material “MIR 24”. Absolutely anyone, even the healthiest person, can become a victim of mental illness. The topic of mental illness has long been a source of inspiration for writers and filmmakers. Thus, the main character of the series “Dangerous Delusion” Alina Kuznetsova lives an ordinary life until she gets into a terrible accident. Waking up in the hospital, the girl discovers that she doesn’t remember anything and, worst of all, she doesn’t recognize her own husband and children. Another problem arises from Alina’s work: before the accident, she was developing a vaccine against a rare deadly virus. Just before the tragedy, the girl managed to deduce the formula for the medicine, but it disappeared from her head along with the rest of the memories of her past life. Not trusting doctors, Alina begins her own investigation.
Will the heroine be able to piece together the picture of events? To find out, watch the series “Dangerous Delusion” on Saturday, October 12, at 22.15 on the MIR TV channel.
Capgras delusion, misrecognition syndrome, delusion of false recognition - this disease has many names. The unusual disorder was first described in 1923 by the French psychiatrist Joseph Capgras. He called the disease “the illusion of doubles.” Here is a typical description of the symptoms of this disease: “Mrs. D., a 74-year-old married housewife... believed that her husband had been replaced by a stranger. She refused to sleep with the impostor, locked her bedroom, asked her son for a gun and fought with the police who came to hospitalize her. Sometimes she believed that her husband was her long-dead father. She easily recognized the rest of the family.” The woman's case, described by psychiatrists Passor and Warnock, clearly demonstrates the presence of Capgras syndrome. It is interesting that in this example we see selective recognition in the patient. However, often patients with this disease cannot recognize any of their loved ones: it seems to them that they have been replaced by doubles. There is even a known case where a patient considered his own cat to be an impostor. Moreover, the man claimed that the cat double was in conspiracy with the FBI and was spying on him. Another famous case: an elderly Frenchman complained for several days that a stranger was in his house. According to him, the uninvited guest was hiding in the mirror and looked exactly like himself.
In addition to the symptoms of a negative twin, there is another type of Capgras syndrome - the so-called positive twin symptom. It is diagnosed in patients who begin to recognize strangers as their acquaintances or family members.
This also includes Fregoli syndrome, named after the famous Italian comedian, known for his ability to instantly change his appearance during a performance. A person with Fregoli syndrome suffers from persecution delusions. He is convinced that someone he knows is constantly following him, constantly changing his appearance beyond recognition. The imaginary stalker can appear in the guise of a man, woman, child, or even an animal or inanimate object.
Capgras syndrome is quite rare. Most often, symptoms appear after 30 years of age. Although there are cases where the disease affected people at a younger age. So, one day a 15-year-old girl came to psychiatrists, claiming that her father and brother tried to put drugs in her food. When the girl’s mother came to visit her at the clinic, she declared her an impostor. But the unfortunate woman suddenly mistook one of the orderlies for her father, declaring that he wanted to injure her.
The causes of this disease are still not fully understood. Capgras syndrome has been diagnosed both in people who have suffered severe head injuries and in patients with other disorders (for example, schizophrenia). The most popular hypothesis is that the disease is still associated with physiological pathology.
The fact is that the visual information that we receive first enters the fusiform gyrus (fusiform). This is where objects, including people's faces, are distinguished. After processing, this data from the fusiform gyrus enters the amygdala, which is responsible for the emotional verification of objects and produces an appropriate emotional reaction. The fusiformis and amygdala are connected by fibers, and if these fibers are damaged, a person's connection between what he sees and what he feels is disrupted. Simply put, people with Capgras syndrome can experience the same emotions as normal people, but because the connection between visual perception and feelings is severed, loved ones no longer evoke any emotional response in them. Imagine seeing your mother, spouse, or child but not feeling anything for them, or suddenly no longer identifying with your reflection. It is not surprising that against this background, the thought of substitution comes to many people’s minds. Because Capgras syndrome often behaves differently, it is not easy to diagnose. Many doctors define it as schizophrenia. Why this happens, explains psychiatrist, general director of the Scientific Center for Personalized Psychiatry, Nadezhda Solovyova. “There are different schools of psychiatry, and the views of psychiatrists in different schools are similar regarding certain most severe disorders, but for many borderline conditions, opinions may differ. And in order to avoid very serious discrepancies among specialists and discrimination of patients, there is an international classification. It changes every decade. The classification of the 10th revision is currently in effect; from 2022, the classification of the 11th revision, already adopted by the World Health Organization, will be mandatory. And depending on what classification we use today, the concept of “schizophrenia” may differ, and radically,” explains Nadezhda Solovyova. In the International Classification of Diseases, 10th revision (ICD-10), Capgras syndrome is not classified as a separate category, the doctor notes. A separate code for this disease will be assigned only in 2022.
“Today, as a rule, they are diagnosed with chronic delusional disorder, since the current classification has such a code. In any case, this is a range of schizophrenia spectrum disorders, if not schizophrenia itself,” says Solovyova.
In her psychiatric practice, she also encountered patients with Capgras syndrome. The doctor noted that this disorder, fortunately, does not always require treatment in a hospital.
“If we are talking about Capgras syndrome, then in outpatient practice this disease occurs more often than in inpatient practice. For example, Cotard's syndrome (a disease in which a person believes himself to be dead - editor's note) is a very severe delusional disorder, and this is just an inpatient case. Such cases, thank God, do not occur so often, because there are drugs that do not allow a person to reach such a state,” says the doctor.
She consoles: despite the severity of the disease, Capgras syndrome is treatable. As a rule, doctors prescribe antidepressants and antipsychotics to a patient with such a disorder, which help bring the condition back to normal.
“We can reverse any delusion if a drug is selected and if it is not a resistant condition,” the psychiatrist emphasizes. – This is when a person, due to the characteristics of his brain receptors, is not sensitive to the effects of drugs. There are not many such cases, but they do happen. It's hard. And generally people respond very well to medications. The main thing here is not to “heal” the patient to such an extent that there are side effects of the drugs, and, having treated delirium, we get some additional diseases.”
It is also noteworthy that, unlike people suffering from, say, an anxiety disorder or various types of phobias, who are most often aware of the illusory nature of their fears and obsessive thoughts, a patient with Capgras syndrome seriously believes that his relatives or himself have been replaced by doubles.
“However, unlike schizophrenia, it is believed that in the treatment of Capgras syndrome it is possible, in parallel with the use of antipsychotics, to engage in cognitive psychotherapy, that is, to work with the patient’s ideas. Which, for example, is meaningless in a purely schizophrenic process. If this is schizophrenic delirium, then psychotherapeutic work is structured differently, not with the goal of dissuading the person,” explains Nadezhda Solovyova. Thus, Capgras syndrome has both some similarities with other mental illnesses and significant differences. In any case, remember the main thing: if you notice symptoms similar to those described in this article in one of your relatives or friends, be sure to ensure that this person receives qualified medical care. Convincing him that he is sick can be very difficult, but the participation of a psychiatrist in such a situation is simply necessary. Don't forget: without proper treatment, any mental disorder can have disastrous consequences.
Ekaterina Solovyova
Causes of Capgras syndrome
Capgras syndrome is complex in nature and varies from patient to patient. It is impossible to identify the causes of the development of this disorder in a particular person without detailed studies of the neural damage that is associated with the syndrome.
The first studies on this topic were related to the possible relationship of brain injuries with Capgras syndrome. Allegedly, after injury, patients are not able to recognize faces consciously, even if they recognize other objects that they knew before. A study dating back to 1984 revealed impaired recognition during autonomic arousal of the brain. It became clear that there are two ways of developing Capgras syndrome - conscious and unconscious.
Studies have also shown the relationship between the presence of doubling paramnesia and the development of Capgras syndrome. This is because these two syndromes can affect the same areas of the brain and for this reason may have the same manifestations (signs).
Since paramnesia most often develops with injury to the frontal lobe of the brain, scientists have suggested that the development of Capgras syndrome is also associated with the condition of the frontal part of the brain. They also noticed that if the connection between another part and the frontal part is disrupted due to injury, this can also cause the development of Capgras syndrome.
Reasons for appearance
The clinical picture is described in detail by world-famous psychiatrists. They professionally studied Capgras syndrome: photos of difficult patients, videos of the most delusional monologues were analyzed in detail by them, and the correct conclusions were drawn. Instead, the causes of the disease still remain vague and not fully understood. They say that the main impetus is damage to the back of the right hemisphere of the brain, which controls the recognition and recognition of people's faces and the appearance of objects. This can result from a severe head injury or unsuccessful surgery.
Another hypothesis states that the appearance of the syndrome has a psychological rather than a physical basis. That is, very severe stress experienced by the patient can lead to this. Often the disease begins to progress much later than the tragedy has occurred. That is, several months, years, even decades may pass after the accident before the syndrome begins to develop. Some psychiatrists admit that the tendency to illness is inherent in the womb of the mother. Others argue: it becomes a consequence of a difficult childhood or authoritarian upbringing.
Glossary of terms
In this section we have collected all the terms that you might encounter in this article. Gradually, we will collect from these explanations a real dictionary of a narcologist-psychiatrist. If some concepts remain unclear to you, leave your comments under the articles on our site. We will definitely help you figure it out.
Affective flattening
– a disorder of affect associated with a significant weakening of emotional reactions, insensitivity, spiritual coldness, and indifference. Affective flattening can be either an independent symptom (with autism, schizophrenia, depression, dementia and other diagnoses) or a side effect of taking certain types of medications or drugs.
Migraine
– a neurological disease characterized by severe and painful headaches in one or both hemispheres. However, there are no obvious reasons for migraines - such as recent head injuries or bruises, strokes and brain tumors, etc. Typically, migraine pain is pulsating and is caused by vascular problems rather than tension. In addition, migraine headache is not associated with changes in blood pressure or intracranial pressure.
Paramnesia
– memory disorders associated with false memories – the patient may confuse the present and the past, real and fictitious events. Many patients tend to overestimate their own participation (both guilt and merit) in certain events of the past. Paramnesia is considered a qualitative perversion of memory.
Paranoid schizophrenia
- a type of schizophrenia, which is characterized by a predominance of hallucinations and delusions, but phenomena such as catatonic syndrome, speech problems, affective flattening and others may not manifest themselves (or manifest themselves weakly). Paranoid schizophrenia is the most common. A mandatory symptom is paraphrenic, paranoid or paranoid delusions. The behavior of patients can be hostile and aggressive, most of them become suspicious, tense, intolerant of others, and irritable.
Paranoid delusions
- one of the main symptoms
of paranoid schizophrenia
. Usually associated with persecutory delusions combined with verbal hallucinations.
Paranoid delusion
– delusion associated with an exaggerated idea of simple life situations. The patient’s statements with this type of delusion are logical, consistent and have strong argumentation.
Paraphrenic delirium
- figurative nonsense of fantastic content. Often accompanied by other mental disorders, such as paramnesia, affective flattening, perceptual deception, etc.
Duplicating (reduplicating) paramnesia
- a type of paramnesia in which the patient thinks that there are two (or more) identical places (for example, somewhere there is exactly the same hospital). Typically, reduplicating paramnesia is associated with damage to the frontal lobe.
Treatment
Treatment for Capgras syndrome depends on the cause of the disease. If it occurs against the background of schizophrenia or another mental disorder, then neuroleptics are used to normalize the condition: Triftazin, Tizercin, Haloperidol, Aminazine, Rispolept, Solean and others. For other types of disorders, other drugs are used to help normalize mental functioning.
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For traumatic brain injuries, treatment is prescribed with great caution, since complete restoration of the nervous system is necessary for recovery.
There were better times in Rostov
Then there were several months of work in the Spanish “Mallorca”, which Karpin unsuccessfully tried to raise from the second Spanish division, a very strange year in a very strange team “Torpedo” (Armavir), after which it began to feel like Valery Georgievich was becoming “Olga Buzova of football” " It especially intensified when Karpin unexpectedly became the editor-in-chief of football broadcasts on the federal sports television channel.
But at the end of 2021, Karpin returned to coaching, signing a contract with Rostov.
Fans of Valery Georgievich believe that in Rostov-on-Don he created a strong team. But if you look at the statistics, it turns out that Rostov with Karpin won 42 matches during his tenure, lost 39 and drew 29. The indicators are average, but nothing more.
Rostov’s best result under Karpin was 5th place in the 2019/20 season. And, in addition, two 9th and one 11th places. At the same time, with Miodrag Bozovic in 2014, Rostov won the Russian Cup, and with Kurban Berdyev in the 2015/16 season, he became the vice-champion of the country, then showing himself more than worthy in the Champions League, where the Rostovites even beat Bayern.
Article on the topic
Rostov is on the verge. Why are Russian football clubs going bankrupt? In general, even in the history of Rostov, Karpin is far from the most “golden” page. And it cannot be said that under this coach the Rostovites began to play some kind of advanced football, captivating with its novelty. Rather, Karpin’s temperament loudly declared itself, constantly starting to pick fights with journalists. Actually, something similar was observed in Spartak, and now, apparently, it will happen in the Russian national team.
Misidentification syndromes
What happens with mistaken identity syndromes is that a person perceives things correctly, they simply interpret them incorrectly. That is, what they see is real, but what they interpret is not real.
There are four different types of mistaken identity syndrome:
- Capgras syndrome: a person falsely perceives that a double has replaced a person close to him (a close relative or friend). But this is not true.
- Fregoli syndrome: A person will think that one or more people have changed their appearance to look more like people they know. The person thinks that they might try to deceive them.
- Intermetamorphosis: a person thinks that the people around him have changed personalities.
- Subjective twin syndrome: a person firmly believes that there are exact doubles.
Which of these mistaken identity syndromes is the most common? This appears to be Capgras syndrome: current evidence suggests that it occurs in 5% of all patients with psychosis.
Diagnosis and treatment
An experienced psychiatrist will always notice alarming symptoms; diagnosing a deviation includes observing the patient and collecting complaints. The doctor notes which ideas prevail in the patient and also interviews his relatives. An X-ray of the brain shows the presence of an organic substance in the human body that affects the functioning of the nervous system.
Any image enters the fusiform gyrus, where recognition of living and nonliving objects occurs. The finished result goes to the amygdala, which is responsible for emotions. If there is damage to the organ, then the connection between perception and mental reactions is broken.
Fregoli delirium is difficult to treat. Not only drug therapy for the disease is important, but also a friendly environment in the patient’s family. A common mistake made by relatives is to try to explain to the patient that he is wrong and that the persecutor does not exist in reality.
Such actions will worsen a person’s well-being, since the delusions of a positive double are accompanied by the ward’s confidence in his own rightness. Psychiatrists associate this illness with delusions of grandeur.
Treatment of Fregoli delirium takes many years. The prognosis of the disease depends on the following factors:
- duration of medication use;
- the presence or absence of other diseases;
- patient's age.
Specialists have to do a lot of work assessing the patient’s condition and drawing up a treatment plan for him.
