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The delusional belief that a close relative has been replaced by a look-alike impostor was named the Capgras delusion in honor of Joseph Capgras, who described the first case. Capgras's original patient, Mme M., had a complex mental illness with various symptoms in addition to the delusion of substitution. The focus in the literature has always been on her eponymous delusion, ignoring the rest of her condition. However, studying the substitution delusion in isolation from the rest of her illness has led to inadequate conclusions. It is necessary to understand the delusion within the broad context of her illness. Toward that goal, her mental illness is described here in detail. A particular pattern of delusions and illness is identified. This same pattern is noted in other cases of Capgras in the literature. Three new cases are reported here, each with the same overall pattern of illness that Mme M. had. This pattern is labeled the Syndrome of Capgras. A hypothesis is offered to explain the Capgras delusion within the context of this illness.
In 1923 Capgras and Reboul-Lachaux reported the case of a woman who had the delusion that close family members were replaced by look-alike impostors. Several years later, as other patients were observed with similar symptoms, the condition was named the Capgras Syndrome in his honor. Over the years it became apparent that it was not a unique syndrome. Rather, it was a delusion that was part of an underlying mental illness, often schizophrenia but other conditions as well, such as mood disorders or brain diseases, particularly Alzheimer's Disease.
In the decade following Capgras's original paper, two additional but rarer syndromes involving false identity and substitution of one person for another were described, the Fregoli Syndrome and the Syndrome of Intermetamorphosis. In the Fregoli Syndrome, the patient holds the belief that a persecutor takes on the appearance of various people at different times, like an actor dressing for a role. In the Intermetamorphosis Syndrome a person is transformed into another person, becoming a different individual. In 1978, the delusion of subjective doubles was described, in which the patient believes that a copy of herself exists elsewhere. Five years later, it was reported that the Capgras delusion and the delusion of subjective doubles...