Capgras syndrome as part of delusional organic disorder

Abstract

Capgras syndrome is a substantial disorder of thought which is characterized by wrong identification of close persons (mistaken identity), i.e. resolute conviction that there is a double, a cheater, in the form of a familiar person. This paper presents an 81-year-old female patient, with an oppositional attitude, occasional psychomotor agitation, verbally aggressive towards the double and the children because they have replaced her husband. She verbalized suicidal intentions and tendencies because she could not stand living with a stranger. Uncertain temporal-spatial orientation, distraction of attention, cognitive deficit, dystrophy, labile affect and global reduction of dynamism were recorded as associated symptoms. The patient and her family refused hospitalization because the ambulatory diagnostic procedures were conducted (CT scan of the head, psychological screening tests and laboratory analyses) and pharmacotherapy was introduced (risperidone, lorazepam), with check-ups in five-day intervals. Within the application of therapy, there was a correction in the identification of the husband, with occasional, short-term ambivalence and the consequent reduction of anxiety, but with persistent spatiotemporal disorientation, distraction of attention and memory deficit. The introduction of drugs for the treatment of dementia was considered, too. Hetero-anamnestic data, neurological and psychiatric status indicated that this patient suffered from a delusion of mistaken identity due to a complex psycho-organic syndrome. Further research of this disease is needed in order to obtain more effective treatment strategies and more complete knowledge of neuropsychological models of facial recognition.