Capgras Syndrome, named after the French scientist Jean Marie Joseph Capgras, is an irrational belief that someone or something familiar has been replaced with something identical.
This syndrome is most commonly seen in neurodegenerative disease patients. Up to 16% of those with Lewy body dementia or Alzheimer’s have Capgras syndrome. This is because neurodegenerative diseases like Alzheimer’s and dementia can alter a person’s sense of reality, causing them to believe that real things are fake.
In some cases, Capgras Syndrome could be selective, for example, a patient could believe that a person is an impostor only when they are in the room, but not over the phone, or vice versa.
There is no concrete proof about what contributes to this disorder. Some researchers believe that it is caused by some physical brain problems, like atrophy, while others believe that it is a combination of physical brain problems and cognitive or psychological factors.
This is due to the basic mechanisms of the brain. When you see someone you recognise, the central nervous system scans the features of the face, and then relays the emotional information related to it. With brain injury caused by trauma or alcohol or other factors, this will not be possible.
However, some research has shown that it might not be due to the person being unable to recognise a place or a person, but because they lack the emotional connection behind it, thus thinking that it is “faked”. For example, with family members, we typically either have strong feelings of love, hate, or others, but people with Capgras possibly do not have that same emotional connection with someone.
While there is no concrete list of symptoms, a research study done by the Mayo Clinic Records showed that most people with Capgras Syndrome have experienced hallucinations, REM sleep behaviour disorders and memory losses.
Currently, there is no treatment for people with Capgras Syndrome. However, current treatments try to aim at the root cause of the Syndrom. For example, if someone with schizophrenia experiences Capgras delusions, physicians would try to treat their schizophrenia by using antipsychotics and therapy (which are typical treatments for schizophrenia).
Capgras Syndrome could co-occur with other delusions, such as:
Reduplicative paramnesia: the feeling that a place such as the hospital or home has been duplicated
Extracampine Hallucinations: the feeling that there are other people’s presence around, that are not seen.
Capgras Syndrome affects the people surrounding the patient more than the patient themselves, since most of the closest caregivers are usually accused of being an impostor.
How to help someone with Capgras Syndrome
Do not contradict them
Though it will most likely be very emotionally draining, the best thing to do is to follow their script. Do not anger or scare them, and also show them that you are not an aggressive symbol. In addition, acknowledge their emotions to further soothe them.
In past cases, caregivers leave the room and pretend to come back as the “real” caregiver, and it works. Even if that doesn’t work, you could come up with creative ideas to distract them.
Reassure them that even though you are not “the real caregiver”, you will still love and care for them. This will make them feel safer and reduce the chances of them hurting themselves and you.