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).
