Capgras Delusion

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Capgras Delusion Door Mind Map: Capgras Delusion

1. Question 1) What problems or symptoms may occur from the disorder? What are common responses to the symptoms and what is the best coping strategy?

1.1. *Responses* Perspective #1: Sullivan, Sean Patrick. "Rare Delusional Disorder Cited in Trial of Actor Tony Rosato." The Hamilton Spectator [Toronto] 8 Oct. 2007: A02. Ebsco Host. Web. 2 May 2014. http://tinyurl.com/ohdn5lr

1.1.1. ABCD: Author is a journalist who is experienced in the field of opinion. There is no bias against the subject. It provides me with information on responses of the subject with the delusion. Published in 2007 , fairly recent.

1.1.1.1. Notes: o Actor and comedian Tony Rosato was convicted of harassing his wife Leah o They were married in 2003 and had a daughter soon after o In 2005, Leah left Rosato for personal/unknown reasons. o About 2 months after her leaving, he began to tell people that his wife and daughter had gone missing and that they were replaced by imposters o According to Dr. Joel Jeffries, a psychiatrist at the Centre for Addiction and Mental Health in Toronto, some patients are more annoyed than angered or frightened at the delusional “switch” o Dr. Jeffries also said that he has never had a patient not recover from the delusion w/o proper treatment. o His diagnosis played a part in his trial and he was eventually avoided any more jail time

1.2. *Problems* Perspective #2:Mazzone, Luigi, et al. "Clinical picture and treatment implication in a child with Capgras syndrome: a case report." Journal of Medical Case Reports 6 (2012): 406. Academic OneFile. Web. 2 May 2014. http://tinyurl.com/lwq5338

1.2.1. ABCD: All authors affiliated with the Child Neuropsychiatry in the Children's Hospital Bambino Gesù, Rome, Italy. No bias, data is a case study. Provides me with the problems a child may face when having CS. Date last updated in 2012.

1.2.1.1. Notes: o Some treatments include anti-depressants or a therapeutic approach, the latter was chosen for this particular patient. o Patient: 11-year-old Caucasian girl with acute delusions and aggressive behavior o Girl showed normal learning abilities and good social skills up until the psychiatric symptoms. o After a short trip that her parents and she went on, she believed that imposters replaced her parents and they were trying to kill/poison her. o She was admitted into a psychiatric children’s hospital. o She experienced depressive mood with frequent sadness and crying, loss of energy and difficulties in sleeping and concentrating o Prosopagnosia: difficulty recognizing faces. o After two months of treatment, she was improving in all areas. o Capgras is very rare in childhood, and even rarer among young

1.3. *Problems* Perspective #1: Iftikhar, Bushra, et al. "What do we know about delusional misidentification disorders? A focus on Capgras syndrome." Neuropsychiatry 2.2 (2012): 111+. Academic OneFile. Web. 1 May 2014. http://tinyurl.com/p54d6dx

1.3.1. ABCD: All authors have written multiple articles in the phycology world. No bias, data consists of facts and a few medical records. Provides me with connections to other mental disorders. Date last updated in 2012.

1.3.1.1. Notes: o Also called the illusion of doubles o Capgras has also been reported to pets being replaced w/other animals. o Can occur because of brain disorders, trauma, metabolic disturbances, toxicities, functional mental illnesses and like all illnesses, can occur without an identifiable cause. o Case #1) 65 year old woman who refused to drink or eat, speak in the presence of her husband of 40 years and was overall depressed.  No evident psychological issues in the past or in ancestry.  Brain scans and cognitive development were all normal.  Quoted by saying “He looks and talks just like my husband, yet someone sent him to spy on me”  Because she wasn’t eating or drinking, some of the delusion may have factored into malnutrition and dehydration.  She was cured of the delusional thinking after being treated with Pharmacotherapy with haloperidol for several days o Case 2) a 34-year-old man with epilepsy who believes his wife and neighbors are imposters.  Wouldn’t accept food from his wife  Patient was prescribed a daily regimen of valproic acid, risperidone and lorazepam  After 5 days of treatment, all delusional thinking was cured. o A disconnection between the inferior temporal cortex and the amygdala may result in this delusional misidentification o May be caused by toxicities such as drugs and alcohol

2. Question 3)How has the discovery of the Capgras Delusion and past research affected of the lives of the patients? How does it affect those who are around them?

2.1. Perspective #1: Hirstein, W., and V. S. Ramachandran. "Capgras Syndrome: A Novel Probe for Understanding the Neural Representation of the Identity and Familiarity of Persons." Proceedings of the Royal Society B: Biological Sciences 264.1380 (1997): 437-44. Print. http://cbc.ucsd.edu/pdf/Capgras%20Syndrome%20-%20P%20Royal%20Soc.pdf

2.1.1. ABCD: Authors are both experienced in the league of psychology. No bias, only facts. Provides me with information on how paitents are responding to treatment. Published in 1997, updated in 2001.

2.1.1.1. Notes: -Capgras is caused by the same part of the brain as deja vu -unless the delusion is severe, there isn't many cases where it cannot be cured -there are many ways to treat Capgras including therapy and medication -in one case of treatment, the father of the patient walked into his sons room and stated that he sent the impostor away and the “real” parent is now back again. It only worked for a short amount of time -a lot of research has been done over the neural basis of memory formation. This relates directly to capgras and other memory related delusions.

2.2. Perspective #2:Burton, M.D., Neel. "A History of Madness." Psychology Today: Health, Help, Happiness + Find a Therapist. Sussex Publishers, LLC, 2 June 2012. Web. 06 May 2014. http://www.psychologytoday.com/blog/hide-and-seek/201206/history-madness

2.2.1. ABCD: Author has the credentials of an MD. Bias may be present, but only in understanding of the information. Provides me with a general understanding of people with the mental disorders in the past. Published in 2011

2.2.1.1. Notes: Used the word”mad” as a general word to describe someone with a mental disorder (from schizophrenia to depression) Madness was thought of as a punishment from God. Thought that it was physically caused by a black bile in one’s body that could be relieved and cured by blood-letting. Once the rise of christianity began, mental illness was supposedly due to a demonic possession In the 17th and 18th centuries the first institution ‘for the humane care of the insane’ was built in the British Isles. In these hospitals, they treated the patients in a moral way unlike the insane asylums. In the 20th century phenomenology was introduced along with new psychologists such as Sigmund Freud.

2.2.1.2. Notes: -Used the word”mad” as a general word to describe someone with a mental disorder (from schizophrenia to depression) -Madness was thought of as a punishment from God. Thought that it was physically caused by a black bile in one’s body that could be relieved and cured by blood-letting. -Once the rise of Christianity began, mental illness was supposedly due to a demonic possession -In the 17th and 18th centuries the first institution ‘for the humane care of the insane’ was built in the British Isles. -In these hospitals, they treated the patients in a moral way unlike the insane asylums. -In the 20th century phenomenology was introduced along with new psychologists such as Sigmund Freud.

3. Synthesis for Question 1) The main symptom of Capgras is seen as when the patient believes that a close friend or family member has been taken over by an imposter who is out to harm or spy on the patient. More often than not, the patient is extremely normal when it comes to cognitive and other testing. Some responses to the symptoms are simply annoyance or confusion that their family member is no longer around. Other responses are more severe such as in the case of Tony Rosato. He is an actor who was diagnosed with Capgras when he was being charged with harassing his ex-wife. He believed that both his wife and daughter were replaced with imposters. He ended up escaping jail time due to being mentally unstable. I believe that the best coping strategy is to treat and wait. The brain is a very delicate organ and is always on its own time. More often than not in Capgras, the brain will heal itself on its own time with a little help from medication and therapy.

4. Synthesis for Question 3) The discovery of Capgras is what led psychologists to researching treatments and the human memory as a whole. It has affected the patients in a way that almost all of them were eventually cured from the delusion in a timely manner. The only was it would affect them badly is if they had a more severe form or if it was only a symptom of a larger, incurable mental illness. The field of mental illness has come a long way from believing causes are black bile and demonic possessions. We now have mental hospitals where the patients are treated in a way more moral way than of those asylums in medieval times which is better on both the families of the patients and the patients themselves. Overall, the impact of research and treatments on both parties were great in size.

5. Question 2) How are Schizophrenia and Capgras Delusion related? How do they differ?

5.1. Perspective #1: Team at NIMH. "Schizophrenia." NIMH RSS. U.S. Department of Health and Human Services, n.d. Web. 05 May 2014. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

5.1.1. ABCD: Authors are affiliated with the team at NIMH , who seem to know a lot about psychology. No bias, only facts. Provides me with information on schizophrenia, in order to compare it to Capgras. Fairly updated.

5.1.1.1. Notes: ◦Affect men and women the same ◦May have physical problems as well as cognitive and mental problems ◦May have delusions: ^Think they are someone else ^Think their relatives are out to get them. ◾Patients may have hallucinations ^hearing voices ^feeling or seeing things that no one else can

5.2. Perspective #2:Abumrad, Jad, and Robert Krulwich. "Seeing Impostors: When Loved Ones Suddenly Aren't." NPR. NPR, 30 Mar. 2010. Web. 06 May 2014. http://www.npr.org/templates/story/story.php?storyId=124745692

5.2.1. ABCD: Authors are experienced when it comes to podcasts and radio, unknown experience on CS. May be biased on the grounds of personal opinion of authors. Provides me with background information on Capgras to compare to schizophrenia. Published in 2010.

5.2.1.1. Notes: ◦May be caused by changes in brain chemistry associated with different mental illnesses, or physical trauma to the brain ◦its as if the “soul of the person isn’t there” in many cases ◦Emotional feeling of not knowing the person wins over the visual ◦during phone calls, the patient recognizes the voices of the subject but does not recognize the subject in person ◦Very rare for a person to not be cured of the delusion if it comes “out of the blue” so to speak, or without cause. ◦may come along with schizophrenia.

5.3. Perspective #3:Freitas FAC, Abrantes ACM, Daker MVD. Capgras delusion and suicide prevention. Casos Clin Psiquiatria [online]. 2011; 13:[4 p.] http://tinyurl.com/ml5ov6l

5.3.1. ABCD: Authors are affiated with the ABP in Brazil, all have proper credentials. Only bias may be in the opinion of the patient in the case. Provides me with a comparison of both schizophrenia and Capgras in one document. Published in 2011.

5.3.1.1. Notes: •Has been debate over whether Capgras is a separate syndrome or just a symptom of a different mental illness. •This study is over a patient with schizophrenia and capgras. •mostly focusing on the relationship between suicide and having capgras along with schizophrenia •patient believed his family was imposters on some days, and on other days he believed that they were trying to leave him the hospital •patient has tried to kill himself 8 times in total •his chronic depression may have been due to either the schizophrenia or the capgras. •limitation on this study would be the fact that not a lot of studies have been done on the relationship between suicide and capgras.

6. Synthesis for Question 2) In Schizophrenia, symptoms that may occur include hallucinations of the senses, thinking they are someone else, or thinking someone is out to get them. This differs from Capgras because the symptoms of that delusion include believing a family member is an imposter who looks exactly like their former self. They also differ in the in Capras, the patient seems to have no mental changes other than the delusion. They are still just as aware of their surroundings and all cognitive tests seem normal, unlike those who have schizophrenia who seem to be in a panic with their delusions and hallucinations. They may relate in the way that Capgras is seen in several case of schizophrenics. It has gotten to the point that Capgras has been debated to be only a symptom of schizophrenia.