Ever Wonder if Your Mom was a Double? Part 1

           In 1923 there was an unusual case in Paris of a woman who complained to the police that there were strange children imprisoned in her basement. She was also convinced that there were more children imprisoned throughout the city. Her delusional state consisted of an elaborate system which centered around two main themes: first, the belief that she had been substituted at birth and was an heiress. Second, the belief of an elaborate plot against her that involved thefts, poisonings, changes in her body’s appearance and substitutions of her family, herself and others in her environment (Sinkman, 2008). Accompanying her misidentification symptoms were psychotic features, persecutory hallucinations and other signs of severe mental illness.  This odd set of symptoms caught the attention of French psychiatrist Joseph Capgras. Capgras’ and Reboul-Lachaux’s research on this woman, later referred to as Mme M., eventually became the basis for a new set of disorders, categorized as “misidentity” or “false identity” syndromes.

Delusional Misidentity Syndrome

            Research with Mme. M led subsequent researchers to discover a whole range of disorders which they classified as Delusional Misidentity Syndrome (DMS). Included in the category is, firstly, Fregoli Syndrome (FS), in which a patient “holds the belief that a persecutor takes on the appearance of various people at different times” (Sinkman, 2008). FS can be associated with a persecutory misidentification of people; however, this is not always the case. It can also be an over-misidentification of one face on others. FS can also extend to misidentification of places as well as people. Second is Intermetamorphosis Syndrome, where the patient believes that an individual can transform into another person. Third, Cotard Syndrome, a disorder consisting of the delusional perception that one is dead or that a particular body part is dead (Berrios & Luque, 1995). Finally, Capgras Syndrome (CS), which will be discussed in detail later on. Variations of misidentity syndromes have arisen in the past; nevertheless, those listed above are the main syndromes within the DMS category. Patients who are diagnosed with a misidentity syndrome often have co-occurring or comorbid disorders such as schizophrenia and paranoia, or other misidentity syndromes (Fialkov & Robins, 1978; Koritar & Steiner, 1988).

Capgras Syndrome

            Capgras Syndrome defined by Joseph Capgras was “the illusion of doubles” (Enoch & Ball, 2001). A current definition of classic Capgras syndrome is a state in which “the patient believes that a person usually closely related to him has been replaced by an exact double” (Nejad & Toofani, 2006). Since Capgras Syndrome was first discovered, there has been a dichotomy in thinking. Some believe the source of CS to be psychological; while others believe it to be organic, resulting from a brain lesion or atrophy (Gluckman, 1968).  Unfortunately, the bulk of research since CS was discovered has shed little light onto the neurological causes. It’s only been very recent that neurological research has been conducted on the disorder. So far explanations for its etiology have varied from “neuro-psychiatric or organic and neurological diseases, including dementia, head trauma, epilepsy, cerebrovascular disease, neurodegenerative disease, most commonly lewy body disease and multiple sclerosis” (Bourget, & Whitehurst, 2004). Behavioral and psychodynamic explanations for Capgras range from “psychosis, paranoia, pathological splitting of a significant other, and changes in the crucial interpersonal relationship” (Berson, 1983).