| Abstract [eng] |
Background. Capgras syndrome is one of the delusional misidentification syndromes (DMS), characterized by a delusional belief that a person emotionally close to the patient has been replaced by an identical impostor. This phenomenon is classified as a delusional disorder and may be either transient or persistent, depending on the underlying pathology. Due to the rarity of the syndrome, heterogeneity of clinical presentation, diagnostic difficulties, and the potential risk of aggression, Capgras syndrome remains a clinically significant yet insufficiently studied condition. Aim of the study. To conduct a systematic literature review aimed at analyzing the epidemiology, etiopathogenesis, clinical features, diagnostic approaches, and treatment options of Capgras syndrome. Materials and methods. A literature search was conducted in international scientific databases and platforms, including PubMed, ScienceDirect, Google Scholar, Wiley Online Library, IntechOpen, StatPearls, DeepDyve, and direct journal publishers’ websites. The following keywords were used: “Capgras syndrome,” “delusional misidentification syndromes,” “delusion of doubles,” and “misidentification delusion.” The search included publications published between 1923 and 2025. Articles published in English and Lithuanian describing cases of Capgras syndrome, its etiopathogenesis, clinical features, diagnostic characteristics, and treatment options were included. Studies unrelated to Capgras syndrome or not corresponding to the selected topic were excluded. Based on article titles and abstracts, some publications were excluded due to failure to meet inclusion criteria. In total, 138 articles were fully reviewed, of which 103 were included in the final literature review. Results. According to the literature, the prevalence of Capgras syndrome in the general population is approximately 0.12%, while its frequency among psychiatric inpatients reaches up to 4.1%. The syndrome most commonly occurs in association with psychiatric disorders, particularly schizophrenia spectrum disorders; however, a substantial proportion of cases are also linked to organic pathology, including neurodegenerative diseases, brain injuries, and cerebrovascular disorders. Etiologically, Capgras syndrome is classified into functional, organic, and, in rare cases, mixed or unspecified forms. Its development may be associated with any pathology affecting the right parietal–occipital and temporal cortical regions of the brain. Clinical presentation varies depending on etiology and may include paranoid delusions, hallucinations, and aggressive behavior. Treatment typically involves antipsychotic medication, management of the underlying condition, and psychotherapy. Successful cases have been reported with the use of atypical antipsychotics, electroconvulsive therapy, and combined treatment approaches; however, standardized treatment guidelines are lacking. Conclusions. Capgras syndrome is a complex and heterogeneous psychopathological phenomenon occurring in the context of various psychiatric and neurological disorders. The clinical presentation, course, and treatment effectiveness largely depend on the underlying etiology. Diagnostic challenges persist, and the risk of aggressive behavior highlights the importance of early recognition and appropriate management of the syndrome. Further research is required to develop more reliable diagnostic algorithms and optimize treatment strategies. |
