Capgra's Syndrome is a disease characterized by the belief of the patient that someone from his closest circle has been replaced by a twin or replaced by himself. Also, the disease can manifest itself in the acceptance of strangers for their own colleagues, acquaintances or relatives. A person suffering from the syndrome described may claim that the bad actions attributed to him have made his “duplicate” exactly the same as him. In other words, this deviation is manifested in the incorrect identification of places, people or objects. The considered syndrome refers to delusional states from the category of delusional ideas.
The causes of the disease
The considered deviation was found in the 23rd year of the last century. This syndrome has acquired its name thanks to its founder, J. Kapgra. Initially, Capra's syndrome was called the illusion of a twin. It was also believed that the described pathology is characteristic only of the female sex. However, the reasons for this conclusion are unknown. Most likely, the basis for this concept was that initially this syndrome was discovered in a woman who did not recognize her own spouse. But in the course of studying this theory has changed, since it turned out that this deviation may be not only a psychiatric ailment, but also be related to neurological pathologies.
Until now, workers of science can not reach a consensus on the root causes of the syndrome. At the same time, they put forward the most likely hypothesis, which is traumatic injury or organic damage to part of the visual cortex, which is responsible for identifying individuals. The recognition disorder can occur due to a stroke, brain injury, aneurysm rupture, neurosurgical intervention, the presence of schizophrenia with paranoid and manic components, alcoholism, senile dementia.
Some scientists, not having a clear understanding of the process of the emergence of Capgra's syndrome, do not consider it a separate ailment. They argue that the combination of the characteristic manifestations of a mental disorder is a subtype of schizophrenia.
Psychologists H. Ellis and E. Youngs made the assumption that patients suffering from this syndrome can form a "mirror image" against the background of the preservation of the conscious ability of face recognition, however, damage to the nervous system segments that produce emotional excitement in familiar objects can occur. Ramachandran and U. Hirstein came to a similar conclusion after analyzing the symptoms in patients after a brain injury.
A number of psychiatrists are inclined to believe that it is the devaluation of the unconscious emotional arousal response that most affects the emergence of Capgra's syndrome. At the same time, a similar picture in individual patients does not show any manifestations of delirium. It was suggested that there is an additional factor causing the transformation into delusions. This factor is considered a depreciation in judgments. However, it is not final.
In addition, Capgra syndrome is associated with paramnesia, which is a memory disorder and is expressed in erroneous memories. Since these syndromes are interrelated, a theory emerged that they have similar neurological consequences. Doubling paramnesia is often formed in the frontal region, so there is an assumption that the syndrome in question is also associated with the frontal segment of the brain. In addition, if the brain damage is located elsewhere, the interruption of impulses between the frontal zone and other lobes may also give rise to the syndrome being analyzed.
Kapgra syndrome psychiatry claims most often affects spouses. A woman who has lost her temper from a family being, enduring the mockery of a despot husband, suffering from depression caused by the birth of a baby, does not want to fall asleep with her spouse, considering him an impostor. The reason for this behavior is not only the above examples, but also neuroses.
Symptoms of Capgras Syndrome
The emergence of the analyzed syndrome is due to psychological nature. Mentally unstable persons are more often exposed to this affliction. Violation of mental activity manifests itself differently, so it is necessary to correctly identify the symptoms of the syndrome in order to isolate the deviation in question from a number of similar disorders. With organic pathologies, memory and abstract thinking are predominantly affected. In order to detect deviations of the associative process, an analysis is made of the patient's remarks that have been voiced during the conversation.
With the considered Capgra syndrome can be observed:
- slowing down of mental activity (manifested by the poverty of associations);
- perseveration (pattern repetition of one thought, due to the atrophic process);
- disconnected thinking (loss of the meaning of the replicas against the background of the preservation of the grammatical structure);
- paralogical thinking (a person makes absurd conclusions after building complex logical inferences);
- lack of speech coherence.
Scientists identify two types of distorted-delusional recognition: the first type of patients claims that their "duplicate" is near (he can feel, they see it), and another type of patients claim that their "duplicate" is invisible (they notice only the results of the alleged action). Such replacements often concern even the pets of patients.
Distorted-perverse form of face recognition of the first type is divided into negative recognition of its own "copies" and positive. Erroneous perception extends to a group of individuals.
In the presence of a negative perception of the twins, the patient is convinced that all the relatives surrounding him are replaced by completely different people who are expertly disguised as relatives. They claim that relatives have been replaced, for example, by aliens or robots, that only external resemblance is preserved.
Patients are constantly looking for confirmation of their own theory and are looking for facts that allegedly confirm the difference between twins and real relatives. Enduring self-righteousness and the presence of stand-ins makes a person an aggressive and suspicious subject. He thinks that the "copies" of the relatives want to harm him. The aggressiveness of these patients is due to their constant tensions and the expectation of trouble.
Distorted positive perception often concerns completely unfamiliar strangers. The patient is convinced that he has long been familiar with them.
The illusory delusional distorted recognition makes patients dangerous. They are wary of "doublers", sometimes they may strive to swap the "correct", in its understanding, faces and "copies". Aggressive actions are based on efforts to do away with "duplicates" by killing them. Patients find it difficult to maintain a calm state, since it seems to them that danger lurks everywhere.
The symptoms of Kapgra syndrome of the second type are due to the lack of self-identification of his own personality, that is, an individual suffering from the analyzed deviation does not perceive himself. This type is also characterized by negative variation and positive. With this variation of the disease, the patient tries to prove to the environment that all the acts and offenses were committed not by his person, but by his “duplicate twin”. He believes that he has nothing to do with perfect actions, his “duplicate” is to blame for everything.
Kapgra syndrome, as well as other psychiatric illnesses, develops gradually. Initially, there are short-term periods of violation of the visual identification of other individuals, lasting up to two minutes. As the disease progresses, seizures become more frequent, their duration increases.
Corrective-therapeutic work should be carried out exclusively in the hospital. The illness is diagnosed, first of all, on the basis of behavioral features and the presence of illusory-delusional symptoms associated with impaired recognition of people. This syndrome is notable for accurate identification of individuals. In this case, the signs that promote recognition of the face are not indicated by the patient, it only states the fact of recognition. The anamnesis has a great value for diagnosing the described syndrome - one of the factors contributing to the onset of the delusional state must be present.
Some mental abnormalities may have a similar clinical picture. Therefore, in order to establish the correct diagnosis, a psychiatrist needs to exclude the following ailments: multiple sclerosis, Alzheimer's disease, schizophrenic spectrum abnormalities, Huntington's disease, brain injury, delusional ideas generated by the use of narcotic drugs or alcohol, overdose with substances that have hallucinatory effect, dementia is depressive manic flow.
Treatment of Capgra's syndrome, above all, involves an individual approach. However, the therapeutic course is quite long. Corrective action should be directly directed to the cause of the disease. In this case, the appointment of antipsychotic drugs does not always give the desired result.
It is also necessary to control the functional mobility of consciousness through strong psychotropic drugs and various manipulations aimed at restoring the normal functioning of the damaged segments of the CNS.
The most effective remedial techniques were cognitive therapies, including reality testing (the human ability to recognize external objects and mental images) and reframing (a technique that changes the point of view, which accordingly changes the perception of an event or object).
Also, the elimination of distorted delusional recognition contributes to antiepileptic therapy. For the correction of depressive moods and anxiety, the appointment of modern antidepressants is shown.
The considered syndrome is characterized by a wave-like course, so during periods of "calm" symptoms, patients are able to control completely their own actions. At the same time, it is not known for certain when a new attack will occur and what can provoke its occurrence.
Stopping the episodes of delusional error should be immediate, as the individual is often able to cause harm to the environment. The relief of seizures is based on an integrated approach with an impact on the root cause. In addition, it is important to limit patients to interacting with people in order to avoid enhancing delusional products. The treatment of such patients is shown sparing, but with the presence of occupational therapy, which loads the muscles and relieves the brain from an excessive amount of useless reasoning.
Summing up, it should be noted that today there is no standard therapeutic regimen to achieve a lasting effect in eliminating the symptoms of Capgra syndrome. In some cases, corrective action is based on the reduction of symptoms. Simply put, the treatment of the underlying disease can help to eliminate the violation of distorted perception of individuals.
Therapy of major ailments may include: surgery, the appointment of antipsychotics or funds aimed at stimulating memory.
In some cases, shows the effect of validation therapy, which helps to reduce anxiety and aggressiveness.
The success of the therapeutic effect is also due to the presence of a comfortable and safe space. Therefore, the interest of relatives in helping a sick relative is important here. You must try to protect close from the effects of stressors, to get rid of conflict situations.