Capgras delusion in postpartum psychosis: a case report

Background Capgras delusion is one of the delusional misidentification syndromes characterized by the belief by the patient that the close person is replaced by an imposter who looks physically the same. It rarely occurs in Postpartum Psychosis. An intriguing phenomenon with ongoing debates, particularly about its feature and prevalence, its course, occurrence, and phenomenon in the postpartum period are poorly understood. Case presentation A 26-year-old Nepalese woman presented to the emergency for abnormal behavior on her 9th postpartum day. Capgras delusion was observed for 2 days during her hospital stay. Other psychotic symptoms appeared progressively and were treated as a case of Postpartum Psychosis. Conclusion This case describes the temporal sequence of various psychopathologies during Postpartum Psychosis including Capgras delusion. We attempt to explain the occurrence of Capgras delusion in Postpartum Psychosis.

Delusional misidentification syndrome and criminal acting out: A case report of maternal filicide

We report the case of a woman with schizoaffective disorder, killing her child under the effect of an impulse motivated by Capgras syndrome in a strange crime scene including evisceration and enucleation. This case help to better understand the association between misidentification syndromes and homicide and to promote preventive measures.

Prevalence and Clinical Implications of the Mirror and TV Signs in Advanced Alzheimer’s Disease and Dementia with Lewy Bodies

Objective: To explore the prevalence and clinical implications of the mirror and TV signs in the moderate to advanced stages of Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Methods: We retrospectively examined the prevalence of clinical and psychiatric symptoms including the mirror and TV signs in 200 subjects with AD and 200 with DLB and evaluated the relationships among the symptoms. Results: The mirror sign was found in 3.0% of AD and 4.5% of DLB subjects. The TV sign was found in 1.5% of AD and 4.0% of DLB subjects. The prevalence of the mirror and TV signs was not significantly different between the AD and DLB groups. Visual hallucination, visual illusion, misidentification of person, and sleep talking were significantly more frequent in DLB than in AD subjects. The mirror sign was significantly associated with lower Mini-Mental State Examination scores, whereas the TV sign was significantly associated with the misidentification of person. Conclusions: Both the mirror and TV signs were rare even in the moderate to advanced stages of AD and DLB. The mirror sign may be independent from other delusional misidentification syndromes (DMSs). Being associated mainly with global cognitive decline, the mirror sign is unlikely attributed to any specific cognitive impairment or the dysfunction of localized brain areas. In contrast, the TV sign was significantly more often coexistent with the misidentification of person, suggesting that the TV sign may partly share common neuropsychological mechanisms with DMSs.

DELUSIONAL MISIDENTIFICATION SYNDROME: DISSOCIATION BETWEEN RECOGNITION AND IDENTIFICATION PROCESSES

Delusional misidentification syndrome (DMS) is an umbrella term for syndromes of intermetamorphosis, Fregoli, and Capgras. DMS) is thought to be related to dissociation between recognition and identification processes. DMS was described for the first time in 1932 as a variant of the Capgras syndrome and is currently on the DSM-V list of diseases as an independent disease entity. Patients affected by DMS believed that people around them, most often family, have changed physically (appearance) and mentally (character). Other symptoms include confabulation, derealization or depersonalization. In patients, aggressive behavior is often observed, aimed at alleged doppelgangers resulting from the sense of being cheated and manipulated. With the intermetamorphosis syndrome, for example, schizophrenia, depression, bipolar disorder or other misidentification syndromes (Fregoli's, Capgras) may coexist. There is also a reverse intermetamorphosis, where the object of the changed appearance or character becomes the patient himself. One of its forms may be lycanthropy. The etiology of the intermetamorphosis has not been fully understood, one of the reasons may be brain damage and changes in the parietal and/or temporal lobes of the right hemisphere. It may then damage long neuronal connections to the frontal areas of the brain, disturbances of working memory (WM) accountable for the keep and online management of data, so that it is available for further processing, and the patient's will be uncritical. The basic method of diagnosis of this delusion is a medical interview with the patient. Other diagnostic methods include computed tomography, magnetic resonance imaging, EEG and ERPs. Experimental methods include searching for the neuromarker of DMS. Currently, there are no treatment guidelines of this delusional disorder, and pharmacotherapy experimental, but the drugs from the group of neuroleptics and lithium seem effective. Some hope for the treatment is created by neurotherapy, but it is also experimental.