What Is Capgras Syndrome?

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Capgras syndrome is a delusional disorder that causes a person to falsely believe that an imposter has replaced a person they know. It’s also known as Capgras delusion. It falls under a class of mental conditions called delusional misidentification syndromes (DMSs).  

Delusional misidentification syndromes are disorders characterized by delusions that cause people to misidentify themselves or those close to them. There are several sub-types, with Capgras syndrome being the most commonly identified.

A person with Capgras syndrome will irrationally believe that an identical-looking impostor has replaced a loved one. They might sometimes think that another being, like an animal or an inanimate object, has been replaced by an imposter.

For instance, a woman might suddenly accuse her child of being an imposter. She may start to harass the child, demanding that they reveal themselves or reveal the location of the person they are impersonating.

Capgras syndrome can affect men and women of all ages. However, it’s more likely to occur in women than men. It’s also an incredibly rare condition affecting between 1 to 4.1% of people withmental health conditions.

Symptoms of Capgras Syndrome 

Capgras syndrome can result in a disturbing set of symptoms that severely affect the quality of life of a person with the condition and their family and friends. The most telling sign of this condition is the belief that an imposter has replaced a loved one, and only the person with the disorder can see through the ‘imposter’s’ disguise.

A person with this condition typically exhibits symptoms around someone they believe to be an imposter. These symptoms could include: 

  • Feeling stressed and anxious when around the ‘imposter’ 
  • Acting violently towards the ‘imposter’
  • Behavioral changes
  • Increased risk of behaving violently towards the ‘imposter’

Capgras syndrome is a highly individual condition, which means people will exhibit symptoms differently. In cases where Capgras syndrome has been linked with another neurological or mental health condition, a person will also display signs of that condition.

Identifying Capgras Syndrome

The condition was first identified by a French psychiatrist named Joseph Capgras in 1923, who classified it as a DMS. However, diagnosing Capgras syndrome today is challenging, which creates difficulty in classifying the disorder.

Scientists are unsure whether to classify it as a neurological or a psychiatric disorder. Some people believe it’s a feature of other delusional disorders. In contrast, others think it’s a different condition that needs to be appropriately identified in the Diagnostic and Statistical Manual of Mental Disorders.

The Diagnostic and Statistical Manual (DSM-5) currently makes no provision for identifying Capgras syndrome, leaving diagnosis up to the discretion and expertise of medical professionals. In making a diagnosis, your doctor will inquire about your medical and family history and any medication you may be on. They’ll also conduct a thorough physical exam and a series of tests to rule out other conditions.

Causes of Capgras Syndrome 

It’s a little unclear what causes Capgras syndrome; however, researchers have developed several working theories to better understand the condition. The most common view seems to be that the disorder is associated with conditions that cause delusions, such as Alzheimer’s disease and dementia.

Other neurological conditions such as Parkinson’s disease, schizophrenia, and schizoaffective disorders have also been linked with Capgras syndrome. In a 2019 review of 255 published cases of Capgras syndrome, researchers found that in 32% of the cases, people diagnosed with the condition also had schizophrenia, 15% had some form of dementia, and 6% had schizoaffective disorder.

Brain damage, especially to the temporal and bifrontal regions, could cause Capgras syndrome. This is because damage to these regions could result in deficits, making facial recognition and processing emotions more challenging.

Treatment for Capgras Syndrome 

Unfortunately, there’s currently no cure for Capgras syndrome, and even treatment can be challenging. If a person with this condition has another mental disorder that has been linked to the condition, treating that mental disorder can sometimes ease symptoms of Capgras syndrome.

For instance, schizophrenia has historically been associated with Capgras Syndrome. Treatment for schizophrenia, which typically involves a combination of therapy and antipsychotic medication, could also alleviate Capgras syndrome symptoms. 

Reality Orientation Therapy 

Reality orientation therapy is a form of treatment used for delusional disorders. This form of therapy focuses on pushing a person experiencing delusions to be confronted with reality by using their environment. Things like the date, time of day, names of people, and places are referenced repeatedly to remind a person of their reality.

Coping and Caregiving

In managing Capgras syndrome, the loved ones of a person with this condition have a significant role to play. The most crucial thing is to be patient with them, understanding that any odd behaviors or moods are caused by the condition and are out of their control.

Other ways you can help a loved one cope with this condition include:

  • Keeping the person away from the ‘imposter’ when they start to become aggravated 
  • Encouraging them to seek help from a medical or mental health professional
  • Calming them when they begin to become agitated
  • Acknowledging their feelings and emotions when having an episode instead of dismissing them
  • Making it clear that you are going to be physically and emotionally available for them throughout the episode

Understandably, the effects of Capgras syndrome can cause a strain on the people around a person with this condition. It’s helpful to do some research to help you understand the symptoms and effects of this condition. 

Capgras syndrome can be challenging to diagnose and manage, like many mental health conditions. The most vital thing to understand is that people with this condition have no control over their thoughts and behaviors.

Capgras syndrome can cause significant distress for the person with the condition and the person they believe to be an imposter, especially when it’s a loved one like a spouse or child. If you or a loved one is exhibiting signs of Capgras syndrome or other delusional disorders, it’s vital to seek medical help as soon as possible.

It’s essential to be prepared for the reality that a person with this condition might never completely recover from it. Seeking joint therapy can go a long way in helping you and them cope with the condition.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Toketemu Ohwovoriole
Toketemu has been multimedia storyteller for the last four years. Her expertise focuses primarily on mental wellness and women’s health topics.