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Prosopagnosia and the Capgras syndrome.

The Capgras syndrome is an unusual psychiatric disorder which has attracted much attention in recent years because of its striking nature and controversial etiology and pathogenesis. The question of whether some cases of Capgras syndrome are an expression of a perceptual disorder of facial recognition, i.e., prosopagnosia, is addressed in this report. Careful testing for a possible prosopagnosia revealed that in 2 newly identified cases of Capgras syndrome, the deficit was present. A deficit of facial recognition could not be appreciably detected in a group of normal female and schizophrenic controls.

Adult

Postictal Capgras syndrome.

The Capgras syndrome of delusions that familiar persons are being impersonated by identical doubles has occasionally been associated with cerebral disease, often of the nondominant hemisphere. A patient with chronic right cerebral hemisphere dysfunction and complex partial seizures of right temporal origin manifested the Capgras syndrome in the postictal state, and the delusions ceased with optimal seizure control. The delusions could result from postictal disinhibition of dominant hemisphere recognition functions, or from dysfunction of nondominant hemisphere centers involved in perceptual integration.

Adult

Temporal lobe involvement in Capgras syndrome.

A Capgras syndrome case is presented. The clinical profile appeared at the onset of treatment with Praziquantel for neurocysticerosis. A left-temporal cysticercum was shown by means of a CT scan. Delusion, accompanied by some neurological symptoms diminished but did not disappear after treatment. The hypotheses for Capgras syndrome are reviewed and it is concluded that it constitutes a cognitive-dysmnesic phenomenon (feeling of unreality, impossibility to integrate recently acquired information with old memory traces) and, as such, its origin is likely temporal.

Adult

Capgras syndrome in adolescence.

Capgras syndrome, the delusion of substitution, has rarely been reported in adolescents. The etiology is unknown, and intense controversy surrounds the debate over the relative importance of biological versus psychological factors. Presented here are two cases of Capgras syndrome in adolescents and a review of the relevant biological, neuropsychological, and psychodynamic literature. The authors suggest that the psychological processes underlying the Capgras delusion are mediated by neuroanatomical connections between various brain areas and hypothesize that the fundamental lesion in Capgras syndrome may be the patient's inability or failure to acknowledge the authenticity of a person they clearly recognize.

Adolescent

The Capgras syndrome in paranoid schizophrenia.

Capgras syndrome is characterized by a delusion of impostors who are thought to be physically similar but psychologically distinct from the misidentified person. This syndrome is generally thought to be relatively rare. Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. In this article, a series of 31 patients suffering from both paranoid schizophrenia and Capgras syndrome is described. Issues pertaining to the phenomenology of Capgras syndrome, the possible relation between Capgras syndrome and other delusional misidentification syndromes, and a neurobiological hypothesis aimed at explaining Capgras syndrome are discussed.

Adult

Capgras syndrome: a literature review and case series.

The authors have presented a description and review of the Capgras Syndrome along with data from a case series of 25 patients with misidentification syndromes (24 Capgras Syndrome, 1 Fregoli Syndrome). From this data, the following conclusions can be drawn: The Capgras Syndrome is not a rare condition, but an uncommon one which is probably frequently overlooked. The misidentification syndrome is not important as a diagnostic entity. It appears in a variety of psychiatric and neurologic conditions. Capgras Syndrome appears to have a possible neurological link in clinicopathological studies; it has been correlated with lesions which produce prosopagnosia. Capgras Syndrome seems to occur more frequently in women, blacks and schizophrenics. Capgras Syndrome had a high (15%) incidence in our adult inpatients diagnosed as having schizophrenia. From this figure we estimate a 0.12% prevalence of Capgras Syndrome in the general population. Capgras Syndrome is often associated with medical illness and when found should signal the alert clinician to investigate for occult organic conditions.

Adult

Brain imaging in a case of Capgras' syndrome.

A patient developed Capgras' syndrome as part of an interictal psychosis of epilepsy; magnetic resonance imaging revealed bilateral subcortical lesions in occipitotemporal and frontal regions. These findings have implications for the postulated association between Capgras' syndrome and neuropsychological deficits, in particular prosopagnosia.

Adult

Capgras' syndrome with organic disorders.

Capgras' syndrome, one form of the delusional misidentification syndromes, is described. Three patients with the syndrome are reported. The first had a right cerebral infarction, the second had nephrotic syndrome secondary to severe pre-eclampsia in the puerperium, and the third had uncontrolled diabetes mellitus with dementia. Evidence is reviewed regarding an organic aetiology for Capgras' syndrome. We conclude that, when the syndrome is present, a thorough search for organic disorder should be made.

Adult

Capgras' syndrome following minor head trauma.

Capgras' syndrome, the delusion of substitution, has been reported in the setting of many different underlying functional and organic conditions. Only two cases of the syndrome following major head trauma have been reported. The authors present the first reported case of Capgras' syndrome following minor head trauma in an elderly woman.

Aged

Capgras syndrome in a patient with migraine.

Capgras syndrome in a patient with migraine is reported. It is difficult to establish whether this association, which has only been reported once before, had aetiological significance or was coincidental. Investigating all cases of Capgras syndrome for organic pathology by MRI is suggested.

Adult

Cotard's syndrome in a patient with coexistent Capgras' syndrome, syndrome of subjective doubles, and palinopsia.

The hallmark of Cotard's syndrome is the delusion of being dead. It is usually seen in affective disorders, and its existence as a separate entity is controversial. A patient is described who presented with paranoid schizophrenia, Cotard's syndrome, the misidentification syndromes of Capgras and subjective doubles, and palinopsia (visual perseveration). Focal theories for these conditions are briefly outlined and the patient is discussed with reference to them. It is proposed that this case supports the concept that Cotard's syndrome is a distinct disorder. The possibility of cerebral dysfunction in the confluence of the parietal, temporal, and occipital regions accounting for this specific clinical presentation is considered.

Adult

Capgras syndrome: two case reports.

Two cases of Capgras syndrome are reported. They constitute further evidence that Capgras syndrome is a delusion which could occur in any psychotic state, rather than a syndrome with specific organic pathology.

Adult

[The Capgras syndrome].

A new case of Capgras' syndrome is presented with a short review on the subject. Since there are many controversies about the etiology of this syndrome, and since some authors explain it with organic factors, others with psychodynamic factors, or a combination of the two, one should be careful with this syndrome to eliminate the presence of organic factors with a meticulous physical examination and appropriate neuropsychological tests. A thorough examination of early interpersonal relations is necessary to verify psychodynamic hypothesis, the most plausible being the splitting of internalized object representations.

Adult

Bilateral atrophy of the frontal and temporal lobes in schizophrenic patients with Capgras syndrome: a case-control study using computed tomography.

The computed tomographic scans of 12 patients with Capgras syndrome and 12 matched controls were blindly assessed. A variety of statistical comparisons between the two groups consistently showed that patients with Capgras syndrome had significantly more bilateral frontal and temporal lobe atrophy. Capgras syndrome may be associated with dysfunction of these areas. Interestingly, all of the index patients had paranoid schizophrenia, and these results suggest the hypothesis that in some schizophrenic patients the presence of Capgras syndrome may be a marker for the coexistence of a focal idiopathic neurodegenerative process that preferentially affects the anterior cerebrum bilaterally.

Adult

Capgras' syndrome: a synthesis of various viewpoints.

The authors review the literature on Capgras' Syndrome and note that there has been little attempt to integrate the various etiological theories into a cohesive synthesis which accounts for both the organic and the psychodynamic theories. It is proposed that Capgras' Syndrome represents a nonspecific symptom of regression to an early developmental stage characterized by archaic modes of thought, resulting from a relative activation of primitive brain centres. Thus, either psychological regression alone or organic disorders that compromise higher cerebral functioning may result in Capgras' Syndrome. Two cases are presented for discussion and elaboration of these concepts.

Adult

Capgras' syndrome and cerebral dysfunction.

Two cases of Capgras' syndrome in association with coarse brain disease are presented. The authors suggest that prosopagnosia (face nonrecognition) may be the primary expression of a specific cerebral dysfunction which forms the basis for a delusional elaboration resulting in Capgras' syndrome.

Adult

Capgras syndrome and dangerousness.

This article discusses Capgras syndrome and its association with harmful and potentially harmful behaviors. Phenomenological and psychodynamic analysis of a series of cases will highlight danger signals that may be present in Capgras patients.

Adult