Capgras syndrome: symptoms, causes and treatment

There are disorders which, due to their nature or their rarity, are very little known to people on the streets. One of them is the Capgras syndrome, What we will define and study today.

What is Capgras syndrome

The person suffering from Capgras syndrome suffers from it delusional ideation, Based on what their loved ones have been replaced by double impostors pretending to be them. It is not exactly that they have difficulty recognizing faces, as in prosopagnosia, as patients with Capgras syndrome recognize facial features that technically define people and therefore have no problem visualizing them. faces. However, they interpret the presence of some people in a delusional way, believing that they are impostors with a perfect costume.

frequent symptoms

Overnight, Capgras syndrome patients claim that some of their loved ones (usually the partner, close relative, or even coworkers) have been replaced by identical duplicates who behave the same, although they present some different aspects.

At this point, the emotional bond that existed between them is broken and thus appears fear, rejection and avoidance. They are not in a position to know why, why or who replaced their loved one, but even if this idea does not make sense, they take it for granted that it is true, and they will interpret all kinds of facts and actions as signs surrounded by impostors.

In short, patients they can recognize other people’s faces but not relate them to emotional meaning that they have, so that they feel that there is a person with the same face and the same features as another and at the same time they do not know how to indicate a concrete and coherent reason why this individual does not is not who he claims to be.

History of this strange syndrome

In 1923, the psychiatrist Jean Marie Joseph Capgras initially described this syndrome under the name of “double illusion” or “illusion of the sosias”: the patient was a 50 year old woman suffering from delusions. On the one hand, he thought he belonged to royalty and, on the other hand, that the people around him had been replaced by duplicates, as there was a secret society that was responsible for the kidnappings of people and the appearance of their doubles.

The trouble arose out of the fact that he had not gotten over the death of his few month old son, and it was then that he began to claim that he had been kidnapped and replaced. After that, she gives birth to two pairs of twins, of which only one daughter survived. After that, her idea of ​​the existence of the network in charge of kidnappings and replacements grew stronger, coming to believe that she had a double herself on the outside during her admission.

Causes of Capgras syndrome

The exact causes of this syndrome are not known, however the most accepted theory is the disconnection between the visual recognition system and the limbic system, In charge of emotional processing.

The visual system processes stimuli through two distinct pathways: on the one hand, the ventral pathway connects the visual cortex with structures responsible for recognizing objects, and on the other hand, the dorsal pathway connects the visual cortex with limbic structures, which provide emotional meaning. Therefore, one could argue that there is a disconnection in the dorsal pathway, as the patient recognizes the relative visually, but does not associate any emotion with it.

Comorbidity with other disorders

This syndrome is linked to other psychotic disorders, such as paranoid schizophrenia, psychotic depression. or other delusional disorders. It can also appear alongside other diseases, whether they are brain tumors, cranioencephalic lesions and dementias, such as Alzheimer’s or Parkinson’s disease, as neurological disorders of this type rarely affect a single person. highly defined type of brain function.


Because Capgras syndrome is rare, there are not many studies on validated and effective treatments. The most widely used and most useful treatment in the medium term is the combination of psychotropic drugs and cognitive behavioral therapy.

1. Psychotropic drugs

As for psychotropic drugs, the following types can be used:

  • antipsychotics, Which are used to combat the delusional idea present in the individual.
  • anticonvulsants, Which are used as a support if necessary.
  • other drugs accords to the pathology it presents.

2. Psychological therapy

If we focus on psychological therapy, cognitive restructuring will be primarily used. Using this technique, the patient will confront his delusional and incoherent idea, making him see that it is his emotional perception that has changed, and that others have not been replaced. In addition, you will be taught how to undertake strategies to compensate for these recognition errors by other means, such as manage the anxiety these mistakes can cause.

It would also be desirable to intervene with the family, because of the emotional cost that the disease represents both for the patient and for relatives.

Capgras syndrome it caused a deterioration of family relations, producing a distancing between the membersAnd this distancing is not practical if we want the family to cooperate in the recovery process. To do this, you need to make sure that they understand the situation and that it is all due to a neurological disorder, not the patient’s decision making.

Finally, it must be taken into account that the patient has a primary pathology from which this syndrome has developed. If this were the case, this pathology would prevail when choosing a treatment and its application.

Bibliographical references:

  • Aziz, VM and Warner, NJ (2005). “Capgras time syndrome”. Psychopathology. 38 (1): pages 49 to 52.
  • Bhatia, MS (1990). “Capgras syndrome in a patient with migraine”. British Journal of Psychiatry. 157 (6): 917-918.
  • Ellis, HD and Young, AW (1990). “Display of delusional false identifications”. The British Journal of Psychiatry. 157 (2): 239-248.

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