What Is Capgras Syndrome?

Medically reviewed by Timothy J. Legg, PhD, CRNP on May 1, 2017Written by Ana Gotter

Overview

Capgras syndrome is a psychological condition. It’s also known as “imposter syndrome” or “Capgras delusion.” People who experience this syndrome will have an irrational belief that someone they know or recognize has been replaced by an imposter. They may, for example, accuse a spouse of being an imposter of their actual spouse. This can be upsetting for both the person experiencing the delusion and the person who is accused of being an imposter.

In some cases, the person experiencing the delusion may believe an animal, object, or even a home is an imposter. Capgras syndrome can affect anyone, but it’s more common in women. In rare cases, it can also affect children.

Causes

Capgras syndrome is most commonly associated with Alzheimer’s disease or dementia. Both of these affect memory and can alter your sense of reality.

Schizophrenia, especially paranoid hallucinatory schizophrenia, can cause episodes of Capgras syndrome. Schizophrenia also affects one’s sense of reality and can cause delusions.

In rare cases, a brain injury that causes cerebral lesions can also cause Capgras syndrome. This is most common when the injury happens in the back of the right hemisphere, as that’s where our brains process facial recognition. People with epilepsy may also experience Capgras syndrome in rare cases.

There are several theories on what causes the syndrome. Some researchers believe that Capgras syndrome is caused by a problem within the brain, like atrophy, lesions, or cerebral dysfunction. Some believe that it’s a combination of physical and cognitive changes, in which feelings of disconnectedness contribute to the problem. Others believe that it’s a problem with processing information or an error in perception, which coincide with damaged or missing memories.

Treatment

Right now, there is no prescribed treatment plan for people with Capgras syndrome because more research needs to be done. But there are treatment options that may help relieve the symptoms.

Treatment aims to address the underlying cause. For instance, if someone with poor symptom control in schizophrenia experiences Capgras syndrome, treating the schizophrenia can improve the Capgras syndrome. However, if Capgras syndrome occurs during the course of Alzheimer’s disease, the treatment options are limited.

The most effective treatment is to create a positive, welcoming environment where the person affected by the syndrome feels safe.

Some care facilities will use validation therapy. In validation therapy, delusions are supported instead of rejected. This can reduce anxiety and panic in the person experiencing the delusion.

Reality orientation techniques may be helpful in some circumstances. This means that the caregiver gives frequent reminders of present time and location, including reminders of major life events, moves, or any substantial changes.

The underlying cause of Capgras syndrome will be treated as much as possible. These treatments may include:

  • Medications like cholinesterase inhibitors, which boost neurotransmitters involved in memory and judgment, for dementia and Alzheimer’s disease
  • Antipsychotics and therapy for people with schizophrenia
  • Surgery, if possible, for brain lesions or head trauma

How to care for someone with Capgras syndrome

Caring for someone with Capgras syndrome can be emotionally demanding, especially if you’re the one they perceive as the imposter. To help someone with Capgras syndrome, here are some strategies to try:

  • Enter their realm of reality when possible. It can help if you try to understand how terrifying it must be for them.
  • Don’t argue with them or try to correct them.
  • Do what you can to make them feel safe. If you’re unsure what to do, you can ask them what they need.
  • Acknowledge their feelings.
  • If possible, have the “imposter” leave the room. If this is you and you’re the caregiver, let someone else take over until the episode is over if you can.
  • Rely on sound. If you know someone is prone to Capgras syndrome, you can make sure the first way they register your appearance is with sound. Greet them out loud before you see them when possible.

Q:

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

A:

Both cause considerable distress for the caregiver as well as the person who has either of these syndromes, but the syndromes are different. In Capgras syndrome, the individual believes that an imposter has taken the place of an important person in their life. In Fregoli syndrome, the person believes that different people are in fact the same person. They believe the person in question is simply changing disguises in order to trick the person with the syndrome.

Timothy J. Legg, PhD, CRNPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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