There are disorders that, due to their nature or rarity, are very little known to ordinary people. One of them is the Capgras syndromewhich today we will define and study.
The person who suffers from Capgras syndrome suffers a delusional ideationbased on the fact that their loved ones have been replaced by double impostors who pretend to be them. It is not exactly that there are difficulties when recognizing faces, as occurs in prosopagnosia, since patients with Capgras Syndrome recognize the facial features that technically define people and therefore do not have problems when recognizing faces. Time to visualize faces. However, they interpret the presence of certain people in a delusional way, believing that they are impostors with a perfect disguise.
Frequent symptoms
From one day to the next, patients with Capgras Syndrome claim that some of their loved ones (usually their partner, a close family member, or even co-workers) have been replaced by identical doubles who behave in the same way, although they present certain different aspects.
At this moment, the emotional bond that existed between them is broken and fear, rejection and avoidance appear. They are not able to know why, for what and who has replaced their loved one, but although this idea makes no sense, they assume that it is true, and They will interpret all types of events and actions as signs that they are surrounded by impostors.
Ultimately, patients They can recognize the faces of others but not connect them with emotional meaning that they possess, so that they feel that there is a person with the same face and features as another and at the same time they do not know how to point out a concrete and coherent reason why that individual is not who they say they are.
History of this rare syndrome
In 1923, the psychiatrist Jean Marie Joseph Capgras He first described this syndrome under the name “illusion of doubles” or “l’illusion des sosies”: the patient was a 50-year-old woman who suffered from delusional ideas. On the one hand, she thought that she belonged to royalty and, on the other, that people around her had been replaced by doubles, since there was a secret society that was responsible for kidnapping people and the appearance of their doubles. .
The disorder arose as a result of not getting over the death of his son who was only a few months old, and it was then that he began to claim that he had been kidnapped and replaced. After this, she again gives birth to two sets of twins, and of them only one girl survived. After this, her idea of the existence of the network in charge of kidnapping and replacing her became stronger, coming to believe that she herself had a double on the outside while she remained hospitalized.
Causes of Capgras Syndrome
The exact causes of this syndrome are not known, but The most accepted theory is the disconnection between the visual recognition system and the limbic systemin charge of emotional processing.
The visual system processes stimuli through two differentiated pathways: on the one hand, the ventral pathway connects the visual cortex with structures responsible for object recognition and, on the other, the dorsal pathway connects the visual cortex with limbic structures, which provide the emotional and affective meaning. Therefore, it could be stated that there is a disconnection in the dorsal pathway, since the patient recognizes the family member visually, but does not associate any emotion with him or her.
Comorbidity with other disorders
This syndrome is linked to other psychotic disorders, such as paranoid schizophrenia, psychotic depression or other delusional disorders. It can also appear together with other diseases, whether brain tumors, craniocerebral injuries and dementias, such as Alzheimer’s or Parkinson’s, given that neurological alterations of this type rarely affect only a very limited type of brain function.
Treatment
Because Capgras Syndrome is rare, There are not many studies on validated and effective treatments. The most used and useful medium-term treatment is a combination of psychotropic drugs and cognitive-behavioral therapy.
1. Psychotropic drugs
As for psychotropic drugs, the following types can be used:
2. Psychological therapy
If we focus on psychological therapy, we will mainly use cognitive restructuring. Through this technique, the patient will confront the delusional and incoherent idea of him, making him see that it is his emotional perception that has changed, and that the others have not been replaced. In addition, you will be taught to undertake strategies to compensate for these recognition failures in other ways, such as deal with the anxiety these mistakes may cause.
It would also be advisable to carry out an intervention with the family, due to the emotional toll that the disease represents on both the patient and the family.
Capgras Syndrome has caused family relationships to deteriorate, producing a distance between membersand such distancing is not convenient if we want the family to cooperate in the recovery process. To do this, you must make sure that they understand the situation and that everything is due to a neurological alteration, and not to the patient’s decision making.
Finally, it must be taken into account whether the patient has a primary pathology from which this syndrome has developed. If this were the case, said pathology would prevail when choosing a treatment and applying it.
