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image of Capgras Syndrome in Dementia: A Systematic Review of Case Studies

Abstract

Background

In an ageing population, dementia has become an imminent healthcare emergency. Capgras syndrome, the most common delusion of misidentification (DMS), is frequently found alongside dementia. Previous research showed that Capgras syndrome has significant negative effects on people living with dementia and their carers due to its complex presentation and impact on their lives. This qualitative systematic review explores the evidence base of the effective management and treatment of Capgras syndrome in dementia.

Aims

As per our knowledge, this is the first systematic review exploring the symptomatology of Capgras syndrome across different types of dementia. Additionally, it aims to identify the treatments used and their efficacy.

Methods

Four databases (EMBASE, MEDLINE, PsycINFO, and CINHAL) were screened in March, 2023. Twenty-six studies met the inclusion criteria and were included in the review. Thematic analysis was performed to explore and synthesise the qualitative findings of the studies. Three conceptual themes were identified: diagnostic tools, Capgras syndrome symptomatology, and Capgras syndrome treatment. Results showed that Capgras syndrome in dementia is not diagnosed and treated in a standardised manner. Following the pharmacological intervention, 28% of cases showed resolution of symptoms, and another 28% experienced improvement. However, 7% of cases reported worsening symptoms, and 10.7% experienced no change. While some patients had positive outcomes with specific medications, others either did not respond or experienced a deterioration of their condition.

Conclusion

The results highlight that there is no single treatment approach for Capgras syndrome in people living with dementia. This underscores the need for person-centred care, where treatment is tailored to individual needs. The review also reveals a heavy reliance on antipsychotic medications and a noticeable lack of psychosocial interventions. Given the limited benefits and significant risks associated with antipsychotics, future research should prioritise developing and testing psychosocial approaches. Additionally, establishing standardised diagnostic criteria and consistent outcome measures for Capgras syndrome in dementia is crucial for evaluating treatment effectiveness and improving care.

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2024-10-15
2024-11-01

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References

  1. Dementia. 2023 Available from: https://www.who.int/news-room/fact-sheets/detail/dementia
  2. What is dementia? 2023 Available from: https://www.dementiauk.org/information-and-support/about-dementia/what-is-dementia/
  3. Edelstyn N.M.J. Oyebode F. A review of the phenomenology and cognitive neuropsychological origins of the Capgras syndrome. Int. J. Geriatr. Psychiatry 1999 14 1 48 59 10029936
    [Google Scholar]
  4. Ballard C. Neill D. O’Brien J. McKeith I.G. Ince P. Perry R. Anxiety, depression and psychosis in vascular dementia: Prevalence and associations. J. Affect. Disord. 2000 59 2 97 106 10.1016/S0165‑0327(99)00057‑9 10837878
    [Google Scholar]
  5. Harciarek M. Kertesz A. The prevalence of misidentification syndromes in neurodegenerative diseases. Alzheimer Dis. Assoc. Disord. 2008 22 2 163 169 10.1097/WAD.0b013e3181641341 18525289
    [Google Scholar]
  6. Förstl H. Almeida O.P. Owen A.M. Burns A. Howard R. Psychiatric, neurological and medical aspects of misidentification syndromes: A review of 260 cases. Psychol. Med. 1991 21 4 905 910 10.1017/S0033291700029895 1780403
    [Google Scholar]
  7. Peritogiannis V. Capgras syndrome and vascular dementia. J. Neuropsychiatry Clin. Neurosci. 2010 22 1 123.e30 10.1176/jnp.2010.22.1.123.e30 20160238
    [Google Scholar]
  8. Pereira G.C.M. Oliveira G.C. Prevalence of Capgras syndrome in Alzheimer’s patients: A systematic review and meta-analysis. Dement. Neuropsychol. 2019 13 4 463 468 10.1590/1980‑57642018dn13‑040014 31844501
    [Google Scholar]
  9. Harwood D.G. Barker W.W. Ownby R.L. Duara R. Prevalence and correlates of Capgras syndrome in Alzheimer’s disease. Int. J. Geriatr. Psychiatry 1999 14 6 415 420 10398349
    [Google Scholar]
  10. Mizrahi R. Starkstein S.E. Jorge R. Robinson R.G. Phenomenology and clinical correlates of delusions in Alzheimer disease. Am. J. Geriatr. Psychiatry 2006 14 7 573 581 10.1097/01.JGP.0000214559.61700.1c 16816010
    [Google Scholar]
  11. Josephs K.A. Capgras syndrome and its relationship to neurodegenerative disease. Arch. Neurol. 2007 64 12 1762 1766 10.1001/archneur.64.12.1762 18071040
    [Google Scholar]
  12. Metin B. Arikan M.K. Kalem S.A. Tarhan N. A case of capgras syndrome with frontotemporal dementia. Cogn. Behav. Neurol. 2019 32 2 134 138 10.1097/WNN.0000000000000191 31205125
    [Google Scholar]
  13. Lipkin B. Capgras syndrome heralding the development of dementia. Br. J. Psychiatry 1988 153 1 117 118 10.1192/bjp.153.1.117 3224233
    [Google Scholar]
  14. Marantz A.G. Verghese J. Capgras’ syndrome in dementia with Lewy bodies. J. Geriatr. Psychiatry Neurol. 2002 15 4 239 241 10.1177/089198870201500410 12489921
    [Google Scholar]
  15. Thaipisuttikul P. Lobach I. Zweig Y. Gurnani A. Galvin J.E. Capgras syndrome in dementia with Lewy bodies. Int. Psychogeriatr. 2013 25 5 843 849 10.1017/S1041610212002189 23211760
    [Google Scholar]
  16. Fishbain D.A. The frequency of Capgras delusions in a psychiatric emergency service. Psychopathology 1987 20 1 42 47 10.1159/000284478 3628676
    [Google Scholar]
  17. Young A.W. Reid I. Wright S. Hellawell D.J. Face-processing impairments and the Capgras delusion. Br. J. Psychiatry 1993 162 5 695 698 10.1192/bjp.162.5.695 8149127
    [Google Scholar]
  18. Alexander M.P. Stuss D.T. Benson D.F. Capgras syndrome. Neurology 1979 29 3 334 339 10.1212/WNL.29.3.334 571979
    [Google Scholar]
  19. Ellis H.D. Young A.W. Accounting for delusional misidentifications. Br. J. Psychiatry 1990 157 2 239 248 10.1192/bjp.157.2.239 2224375
    [Google Scholar]
  20. Pandis C. Agrawal N. Poole N. Capgras’ delusion: A systematic review of 255 published cases. Psychopathology 2019 52 3 161 173 10.1159/000500474 31326968
    [Google Scholar]
  21. Fiacconi C.M. Barkley V. Finger E.C. Carson N. Duke D. Rosenbaum R.S. Gilboa A. Köhler S. Nature and extent of person recognition impairments associated with Capgras syndrome in Lewy body dementia. Front. Hum. Neurosci. 2014 8 726 10.3389/fnhum.2014.00726 25309399
    [Google Scholar]
  22. Page MJ. McKenzie JE. Bossuyt PM. Boutron I. Hoffmann TC. Mulrow CD. Shamseer L. Tetzlaff JM. Akl EA. Brennan SE. Chou R. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021 372 n71 10.1136/bmj.n71.
    [Google Scholar]
  23. Joanna Briggs Institute Joanna briggs institute critical appraisal checklist for studies reporting prevalence data. Adelaide. JBI Library Syst. Rev. 2017 2017 1
    [Google Scholar]
  24. Braun V. Clarke V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006 3 2 77 101 10.1191/1478088706qp063oa
    [Google Scholar]
  25. Mendez M.F. Delusional misidentification of persons in dementia. Br. J. Psychiatry 1992 160 3 414 416 10.1192/bjp.160.3.414 1562874
    [Google Scholar]
  26. Wrigley M. Capgras’ syndrome in a patient with dementia. Br. J. Psychiatry 1987 151 2 273 274 10.1192/S0007125000216371 3690129
    [Google Scholar]
  27. ØStergaard P.K. Capgras syndrome in senile dementia of the Alzheimer type. J. Am. Geriatr. Soc. 1985 33 11 811 10.1111/j.1532‑5415.1985.tb04197.x 4056277
    [Google Scholar]
  28. Baldwin R.C. Snowden J.S. Mann D.M.A. Delusional misidentification in association with cortical lewy body disease—A case report and overview of possible mechanisms. Int. J. Geriatr. Psychiatry 1995 10 10 893 898 10.1002/gps.930101014
    [Google Scholar]
  29. Edelstyn N.M.J. Oyebode F. Barrett K. The delusions of Capgras and intermetamorphosis in a patient with right-hemisphere white-matter pathology. Psychopathology 2001 34 6 299 304 10.1159/000049328 11847489
    [Google Scholar]
  30. Förstl H. Almeida O.P. Iacoponi E. Capgras delusion in the elderly: The evidence for a possible organic origin. Int. J. Geriatr. Psychiatry 1991 6 12 845 852 10.1002/gps.930061204
    [Google Scholar]
  31. Jedidi H. Daury N. Capa R. Bahri M.A. Collette F. Feyers D. Bastin C. Maquet P. Salmon E. Brain metabolic dysfunction in Capgras delusion during Alzheimer’s disease: A positron emission tomography study. Am. J. Alzheimers Dis. Other Demen. 2015 30 7 699 706 10.1177/1533317513495105 23813791
    [Google Scholar]
  32. Margetić B. Capgras syndrome associated with Bromazepam in a patient with vascular dementia. Clin. Neuropharmacol. 2020 43 6 202 10.1097/WNF.0000000000000418 33060533
    [Google Scholar]
  33. Oyebode F. Edelstyn N.M.J. Patel A. Riddoch M.J. Humphreys G.W. Capgras syndrome in vascular dementia: Recognition memory and visual processing. Int. J. Geriatr. Psychiatry 1996 11 1 71 73 10.1002/(SICI)1099‑1166(199601)11:1<71::AID‑GPS322>3.0.CO;2‑C
    [Google Scholar]
  34. Tsai S.J. Hwang J.P. Yang C.H. Liu K.M. Lo Y. Capgras’ syndrome in a patient with vascular dementia: A case report. Kaohsiung J. Med. Sci. 1997 13 10 639 642 9385782
    [Google Scholar]
  35. Mi Y. Qin Q. Xing Y. Tang Y. Capgras Syndrome as the Core Manifestation of Early-Onset Alzheimer’s Disease. J. Alzheimers Dis. 2022 87 1 155 160 10.3233/JAD‑215565 35253758
    [Google Scholar]
  36. Ng K.P. Wong B. Xie W. Kandiah N. Capgras syndrome in the young: Schizophrenia or Alzheimer disease? Alzheimer Dis. Assoc. Disord. 2020 34 1 94 96 10.1097/WAD.0000000000000360 31913960
    [Google Scholar]
  37. Oulis P. Dimitrakopoulos S. Konstantakopoulos G. Tsaltas E. Kollias K. Capgras delusion in paranoid schizophrenia complicated by vascular dementia. J. Neuropsychiatry Clin. Neurosci. 2012 24 3 E28 10.1176/appi.neuropsych.11070162 23037670
    [Google Scholar]
  38. Ray S. Park D. Burdick .D Delusional Misidentification Syndrome for “Self” in two patients with Parkinson`s Disease. 2017 Available from: https://www.mdsabstracts.org/abstract/delusional-misidentification-syndrome-for-self-in-two-patients-with-parkinsons-disease/
  39. Shiotsuki H. Motoi Y. Nakamura S.I. Mizuno Y. Hattori N. Dopamine deficiency may lead to capgras syndrome in Parkinson’s disease with dementia. J. Neuropsychiatry Clin. Neurosci. 2010 22 3 352.e14 352.e15 10.1176/jnp.2010.22.3.352.e14 20686153
    [Google Scholar]
  40. Kaufman KR. Newman NB. Dawood A. Capgras delusion with violent behavior in Alzheimer dementia: Case analysis with literature review. Ann Clin Psychiatry 2014 26 3 187 91 24812655
    [Google Scholar]
  41. Reimers K. Emmert N. Shah H. Benedict R.H.B. Szigeti K. Capgras-like visual decomposition in Lewy body dementia with therapeutic response to donepezil. Neurol. Clin. Pract. 2014 4 6 467 469 10.1212/CPJ.0000000000000068 25566416
    [Google Scholar]
  42. Roane D.M. Rogers J.D. Robinson J.H. Feinberg T.E. Delusional misidentification in association with parkinsonism. J. Neuropsychiatry Clin. Neurosci. 1998 10 2 194 198 10.1176/jnp.10.2.194 9608408
    [Google Scholar]
  43. Koga S. Dickson D.W. Wszolek Z.K. Capgras syndrome in dementia with Lewy bodies: A possible association of severe cortical Lewy body pathology. Neurol. Neurochir. Pol. 2021 55 6 592 594 10.5603/PJNNS.a2021.0086 34846065
    [Google Scholar]
  44. Edelstyn N.M.J. Oyebode F. Barrett K. Delusional misidentification: A neuropsychological case study in dementia associated with parkinson’s disease. Neurocase 1998 4 3 181 188 10.1080/13554799808410620
    [Google Scholar]
  45. Kumar V. Capgras syndrome in a patient with dementia. Br. J. Psychiatry 1987 150 2 251 10.1192/bjp.150.2.251 3651683
    [Google Scholar]
  46. Cannas A. Meloni M. Mascia M.M. Solla P. Cocco L. Muroni A. Floris G. Di Stefano F. Marrosu F. Capgras syndrome in Parkinson’s disease: Two new cases and literature review. Neurol. Sci. 2017 38 2 225 231 10.1007/s10072‑016‑2765‑9 27848117
    [Google Scholar]
  47. Migliorelli R. Tesón A. Sabe L. Petracchi M. Leiguarda R. Starkstein S.E. Prevalence and correlates of dysthymia and major depression among patients with Alzheimer’s disease. Am. J. Psychiatry 1995 152 1 37 44 10.1176/ajp.152.1.37 7802118
    [Google Scholar]
  48. Koc AE. Hocaoglu C. What is Capgras Syndrome? Diagnosis and Treatment Approach. Anxiety Disorders - The New Achievements IntechOpen 2021 1 16 10.5772/intechopen.91153.
    [Google Scholar]
  49. Bienenfeld D. Brott T. Capgras’ syndrome following minor head trauma. J. Clin. Psychiatry 1989 50 2 68 69 2914883
    [Google Scholar]
  50. Brighetti G. Bonifacci P. Borlimi R. Ottaviani C. “Far from the heart far from the eye”: Evidence from the Capgras delusion. Cogn. Neuropsychiatry 2007 12 3 189 197 10.1080/13546800600892183 17453900
    [Google Scholar]
  51. Cahill S. Shapiro M. ‘I think he might have hit me once’: Aggression towards caregivers in dementia care. Aust. J. Ageing 1993 12 4 10 15 10.1111/j.1741‑6612.1993.tb00612.x
    [Google Scholar]
  52. Coyne A.C. Reichman W.E. Berbig L.J. The relationship between dementia and elder abuse. Am. J. Psychiatry 1993 150 4 643 646 10.1176/ajp.150.4.643 8465884
    [Google Scholar]
  53. Cooper C. Selwood A. Blanchard M. Livingston G. Abusive behaviour experienced by family carers from people with dementia: the CARD (caring for relatives with dementia) study. J. Neurol. Neurosurg. Psychiatry 2010 81 6 592 596 10.1136/jnnp.2009.190934 19955110
    [Google Scholar]
  54. World Health Organization Global status report on the public health response to dementia. 2021 Available from: https://iris.who.int/bitstream/handle/10665/344701/9789240033245-eng.pdf
    [Google Scholar]
  55. Lindeza P. Rodrigues M. Costa J. Guerreiro M. Rosa M.M. Impact of dementia on informal care: A systematic review of family caregivers’ perceptions. BMJ Support. Palliat. Care 2024 14 e1 e38 e49 10.1136/bmjspcare‑2020‑002242 33055092
    [Google Scholar]
  56. Miwa H. Mizuno Y. Capgras syndrome in Parkinson’s disease. J. Neurol. 2001 248 9 804 805 10.1007/s004150170097 11596786
    [Google Scholar]
  57. Cascade E. Kalali A.H. Mehra S. Meyer J.M. Real-world data on atypical antipsychotic medication side effects. Psychiatry (Edgmont) 2010 7 7 9 12 20805913
    [Google Scholar]
  58. Schneider L.S. Dagerman K.S. Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: Meta-analysis of randomized placebo-controlled trials. JAMA 2005 294 15 1934 1943 10.1001/jama.294.15.1934 16234500
    [Google Scholar]
  59. Scott I. Cooper C. Leverton M. Burton A. Beresford-Dent J. Rockwood K. Butler L. Rapaport P. Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials. Int. J. Geriatr. Psychiatry 2019 34 10 1386 1402 10.1002/gps.5127 31026082
    [Google Scholar]
  60. Spiegel D.R. Laroia R. Samuels D. A possible case of Capgras syndrome after a right anterior cerebral artery cerebrovascular accident treated successfully with mirtazapine. J. Neuropsychiatry Clin. Neurosci. 2008 20 4 494 10.1176/jnp.2008.20.4.494 19196939
    [Google Scholar]
  61. Jariwala P.C. Shah N.D. Dave K.R. Mehta R.Y. Delusional misidentification syndromes in patients of paranoid schizophrenia: case series and review. Telangana J Psychiatry. 2017 3 2 125 129
    [Google Scholar]
  62. de Pauw K.W. Psychodynamic approaches to the Capgras delusion: A critical historical review. Psychopathology 1994 27 3-5 154 160 10.1159/000284864 7846232
    [Google Scholar]
  63. Coltheart M. Langdon R. McKay R. Schizophrenia and monothematic delusions. Schizophr. Bull. 2007 33 3 642 647 10.1093/schbul/sbm017 17372282
    [Google Scholar]
  64. Enoch M.D. Ball H.N. Uncommon Psychiatric Syndromes. Hodder A. CRC Press 2001
    [Google Scholar]
  65. Banerjee S. The use of antipsychotic medication for people with dementia: Time for action. Available from: https://www.psychrights.org/research/digest/nlps/BanerjeeReportOnGeriatricNeurolepticUse.pdf
/content/journals/car/10.2174/0115672050335918240919073012
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Capgras Syndrome in Dementia: A Systematic Review of Case Studies
Bentham Science Publishers ; https://doi.org/10.2174/0115672050335918240919073012
/content/journals/car/10.2174/0115672050335918240919073012
/content/journals/car/10.2174/0115672050335918240919073012
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  • Article Type: Review Article
Keywords: dementia ; case report ; treatment ; symptomatology ; case study ; Capgras syndrome ; systematic review

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