Delusional Misidentification Syndromes and Dementia

Cipriani, Gabriele; Vedovello, Marcella; Ulivi, Martina; Lucetti, Claudio; Fiorino, Andrea Di; Nuti, Angelo

doi:10.1177/1533317513506103

Cited by 48 publications

(22 citation statements)

References 99 publications

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“…Capgras syndrome). 29 Sensory impairment is widely considered a contributory factor in the development of certain delusions in dementia, most obviously in cases of Charles Bonnet syndrome in the context of visual impairment.…”

Section: Clinical Presentation Of Bpsdmentioning

confidence: 99%

Best practice in the management of behavioural and psychological symptoms of dementia

Tible¹,

Riese

Savaskan

et al. 2017

Ther Adv Neurol Disord

243

246

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Behavioural and psychological symptoms of dementia (BPSD) occur in most patients with dementia. They cause great suffering in patients and caregivers, sometimes more so than the cognitive and functional decline inherent to dementia. The clinical features of BPSD include a wide variety of affective, psychotic and behavioural symptoms and signs. The causes and risk factors for BPSD are multiple and include biological, psychological and environmental variables. Frequently, their combination, rather than any specific factor, explains the occurrence of BPSD in an individual patient. Thus, a sound etiopathogenetic investigation including the patient and the family or care team is essential. The aim is to develop an individualized treatment plan using a therapeutic decision tree modified by the individual and environmental risk profile. Still, treatment may be difficult and challenging. Clinical empiricism often steps in where evidence from controlled studies is lacking. Psychosocial treatment approaches are pivotal for successful treatment of BPSD. Often a combination of different non-pharmacological approaches precedes drug treatment (most of which is off-label). Regular assessments of the treatment plan and any prescriptions must be carried out to detect signs of relapse and to stop any medicines that may have become inappropriate. Even with optimal management, BPSD will not disappear completely in some cases and will remain challenging for all involved parties. This article is a narrative review based closely on the interprofessional Swiss recommendations for the treatment of BPSD. To establish the recommendations, a thorough research of the literature has been carried out. Evidence-based data were provided through searches of Medline, Embase, ISI and Cochrane-Database research. Evidence categories of the World Federation of Biological Societies were used. Additionally, the clinical experience of Swiss medical experts was considered.

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Section: Clinical Presentation Of Bpsdmentioning

confidence: 99%

Best practice in the management of behavioural and psychological symptoms of dementia

Tible¹,

Riese

Savaskan

et al. 2017

Ther Adv Neurol Disord

243

246

View full text Add to dashboard Cite

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“… 10 They are a psychopathologic phenomena in which a patient consistently misidentifies persons, places, objects, or events. 11 There are several clinical subtypes of DMS such as Capgras syndrome, reduplicative paramnesia, Fregoli delusion, Cotard syndrome, intermetamorphosis, reverse-intermetamorphosis, and misidentification of reflection. 12 Despite distinctive differences, these phenomena seem to share the core feature of a profound change in perception of reality and may also share a common neurobiological substrate.…”

Section: Discussionmentioning

confidence: 99%

Capgras syndrome associated with limbic encephalitis in a patient with diffuse large B-cell lymphoma

Neto

Cavalcante

Martins-Filho

et al. 2016

Dement. neuropsychol.

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We report the case of a patient with insidious onset and slowly progressive cognitive impairment, behavioral symptoms, temporal lobe seizures and delusional thoughts typical of delusional misidentification syndromes. Clinical presentation along with extensive diagnostic work-up revealed limbic encephalitis secondary to diffuse large B-cell lymphoma. The patient underwent immunotherapy with high-dose corticosteroid but no significant improvement was observed. No specific treatment for lymphoma was performed because the patient died of septic shock following a nosocomial respiratory infection. Delusional misidentification syndromes are an unusual and unique form of cognitive impairment in which a patient consistently misidentifies persons, places, objects, or events. Capgras syndrome is the most common subtype of this disorder, being defined by the recurrent and transient belief that someone close has been substituted by an imposter. These entities are generally associated with neurodegenerative diseases and psychiatric disturbances. Rare reports of associations between misidentification syndromes and autoimmune diseases such as multiple sclerosis have been published, but no papers address a correlation with limbic encephalitis or lymphoma.

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“…Identification disorders like CS are very frequent in neurodegenerative diseases [7]. Regarding the organic conditions that occur in Capgras delusion, this appears mainly in various types of dementia like Alzheimer, Lewy bodies, and Parkinson [39]. The prevalence of CS in Lewy body dementia may be as high as 25% and 10% in Alzheimer-type dementia.…”

Section: Neuroanatomical and Neuropsychological Impairments In Capgramentioning

confidence: 99%

What is Capgras Syndrome? Diagnosis and Treatment Approach

Koc¹,

Hocaoğlu²

2021

Anxiety Disorders - The New Achievements

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Capgras delusion is a complex psychopathological phenomenon that presents in a wide range of psychiatric and neurological disorders with differing patterns dependent on the main etiology. An underlying neurological disease should be suspected where the delusion concerns a spouse or inanimate objects and is associated with visual hallucinations, while a functional disorder is suggested by multiple imposters, strangers, additional delusions, and auditory hallucinations. Misidentifications in Capgras syndrome (CS) are fixed false beliefs and, therefore, represent true delusions. Even if when patients are confronted over and over with the illogical nature of the delusion, they keep their beliefs. Surprisingly, patients may show implicit or explicit awareness of their true situation. Some research suggests that a considerable number of patients with CS have some awareness of the bizarre nature of the misidentification delusions and therefore tend not to report them, especially during initial interviews when they are less likely to be confident with the clinician. Specific questions and interventions may assist clinicians in successfully identifying patients with CS. In a series of interviews with these patients, some focus on identifying CS, rather than a single interview which is likely to increase the detection of the delusional misidentification. The clinician should always be mindful of the risk of aggression and homicide in CS.

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Delusional Misidentification Syndromes and Dementia

Cited by 48 publications

References 99 publications

Best practice in the management of behavioural and psychological symptoms of dementia

Best practice in the management of behavioural and psychological symptoms of dementia

Capgras syndrome associated with limbic encephalitis in a patient with diffuse large B-cell lymphoma

What is Capgras Syndrome? Diagnosis and Treatment Approach

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