Capgras Syndrome

What is Capgras syndrome?

Capgras syndrome, sometimes known as Capgras delusion, is an uncommon psychological condition where you mistakenly believe an imposter is taking the place of a family member or close friend. It’s a type of delusional misidentification syndrome.

Capgras syndrome may be a complication of several neurodegenerative diseases or mental health conditions. Treatment includes antipsychotic medications to ease the symptoms, as well as continuing treatment for the underlying cause.

What are Capgras syndrome symptoms?

The overarching symptom is that you truly believe there’s an imposter in place of someone you recognize and know well. Often that person is your primary caregiver. When you see this person, you may react by:

• Becoming agitated, angry or upset.
• Refusing to talk to them or to talk to others when that person is present.
• Saying the imposter makes you feel anxious or afraid.
• Showing aggressive behavior like threatening the imposter or attempting to attack them physically.
• Refusing to believe any evidence that the person that you think is an imposter really is a family member or friend.
• Becoming focused on exposing the imposter.

What causes Capgras syndrome?

There’s no single known cause. Some research suggests it develops because there’s a disconnect between your temporal lobe, which manages facial recognition, and your amygdala, which, in this case, processes your immediate emotional response when you recognize someone. In Capgras syndrome, you recognize someone, but you don’t believe that they’re the same person you love and trust.

Other potential causes are:

• Brain injury: Traumatic brain injury may damage your temporal cortex or your amygdala and lead to Capras syndrome.
• Mental health conditions: Schizophreniform disorder, schizophrenia, bipolar disorder and depression are examples of mental health conditions associated with Capgras syndrome.
• Neurodegenerative diseases: Alzheimer’s disease, advanced Parkinson’s disease, dementia or Lewy body dementia are potential causes.
• Other central nervous system conditions: Epilepsy, cerebrovascular accidents, infectious diseases or exposure to toxins may cause this condition.

What are the complications of Capgras syndrome?

Capgras syndrome typically affects people with a neurodegenerative disease or a mental health condition. Capgras syndrome may be one more medical or mental health challenge they must manage.

Capgras syndrome also affects the person identified as the imposter. Often that’s the primary caregiver who may already have stress from being responsible for someone with a neurodegenerative disease or mental illness. Studies show caregivers identified as imposters feel anxious, depressed, isolated and have trouble sleeping.

How is Capgras syndrome diagnosed?

Healthcare providers will do a physical examination and take a complete medical history. They’ll ask you about conditions that may increase your risk for Capgras syndrome. They’ll also do the following tests:

• Neurological examination.
• Imaging tests, like computed tomography (CT) scans and magnetic resonance imaging (MRI).

What are the treatments for Capgras syndrome?

Healthcare providers may prescribe antipsychotic medications that relieve the condition’s symptoms like:

• Aripiprazole (Abilify®).
• Olanzapine (Zyprexa®).
• Quetiapine (Seroquel®).

They may also recommend psychological therapy like cognitive behavioral therapy (CBT). Therapy should demonstrate empathy and emphasize interest in what the person with Capgras syndrome is experiencing. It’s important that therapy avoids confronting the person about their beliefs.

Can Capgras syndrome go away?

The condition doesn’t go away without treatment. Antipsychotic medication and treatment like counseling often ease symptoms.

What is the life expectancy for someone with Capgras syndrome?

This condition doesn’t affect life expectancy. In this case, life expectancy is tied to the underlying cause.

How do I take care of my family member?

With Capgras syndrome, your loved one is living with a different reality — one where you, another family member or a close friend is an imposter. There’s nothing you can say to convince them otherwise. Treatment with antipsychotic medications is the only way to resolve the issue, but the following suggestions may also help:

• Accept the situation: Trying to prove you aren’t or someone else isn’t an imposter may increase tension between you and your family member. Trying to convince them that they’re wrong can lead to anger and aggression.
• Announce yourself: Capgras syndrome doesn’t seem to affect voice recognition. Saying hello before you appear in your family member’s sight may reduce the chance they’ll react.
• Find a short-term substitute: Asking someone to step in as primary caregiver isn’t a permanent solution. But taking a break may help ease tension between you and your family member.

When should my family member see their healthcare provider?

You should contact a healthcare provider as soon as you suspect that your family member believes that you or another person is an imposter.

Is Capgras syndrome the same as Fregoli syndrome?

No, it’s not. Fregoli syndrome is another type of delusional misidentification syndrome. The difference is that people with Fregoli syndrome believe someone they know keeps showing up in disguise to give the impression they’re different people.

What’s the difference between imposter syndrome and Capgras syndrome?

In imposter syndrome, you constantly question your intelligence, skills and abilities.