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Capgras delusion for animals and inanimate objects in Parkinson's Disease: a case report.
BMC Psychiatry 2015; 15:73BP

Abstract

BACKGROUND

Capgras delusion is a delusional misidentification syndrome, in which the patient is convinced that someone that is well known to them, usually a close relative, has been replaced by an impostor or double. Although it has been frequently described in psychotic syndromes, including paranoid schizophrenia, over a third of the documented cases of Capgras delusion are observed in patients with organic brain lesions or neurodegenerative disease, including Parkinson's Disease. Variants of Capgras involving animals or inanimate objects have also been described. The etiology of Capgras in Parkinson's remains unclear, but may arise from a combination of factors, such as frontal lobe dysfunction and dopaminergic medication.

CASE PRESENTATION

We present the case of a 53-year old right-handed female with Parkinson's disease who developed Capgras delusion during treatment with dopamine agonists and Levodopa/Carbidopa. She became convinced that her pet dogs and the plants in her garden had been substituted by identically looking ones. Our patient was initially treated with Quetiapine, with no improvement, and subsequently treated with Clozapine, which lead to partial regression of her symptoms. Neuropsychological Evaluation showed Mild Cognitive Impairment in Executive Functions.

CONCLUSIONS

Given the clinical history, onset and evolution of symptoms we believe our patient's delusion resulted from the overlap of dopaminergic medication and Mild Cognitive Impairment in executive functions. Zoocentric Capgras, the variant we describe, has been rarely described in scientific literature, and we believe it is of interest due to its unusual characteristics.

Authors+Show Affiliations

University of Milan Medical School, Ospedale San Paolo, Via A.Di Rudini 8, 20142, Milan, Italy. lucrezia.islam@unimi.it.Movement Disorder Department, Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy. piacentini@istituto-besta.it.Movement Disorder Department, Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy. Paola.Soliveri@istituto-besta.it.University of Milan Medical School, Ospedale San Paolo, Via A.Di Rudini 8, 20142, Milan, Italy. Silvio.Scarone@unimi.it.University of Milan Medical School, Ospedale San Paolo, Via A.Di Rudini 8, 20142, Milan, Italy. Orsola.Gambini@unimi.it.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25886646

Citation

Islam, Lucrezia, et al. "Capgras Delusion for Animals and Inanimate Objects in Parkinson's Disease: a Case Report." BMC Psychiatry, vol. 15, 2015, p. 73.
Islam L, Piacentini S, Soliveri P, et al. Capgras delusion for animals and inanimate objects in Parkinson's Disease: a case report. BMC Psychiatry. 2015;15:73.
Islam, L., Piacentini, S., Soliveri, P., Scarone, S., & Gambini, O. (2015). Capgras delusion for animals and inanimate objects in Parkinson's Disease: a case report. BMC Psychiatry, 15, p. 73. doi:10.1186/s12888-015-0460-7.
Islam L, et al. Capgras Delusion for Animals and Inanimate Objects in Parkinson's Disease: a Case Report. BMC Psychiatry. 2015 Apr 8;15:73. PubMed PMID: 25886646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Capgras delusion for animals and inanimate objects in Parkinson's Disease: a case report. AU - Islam,Lucrezia, AU - Piacentini,Sylvie, AU - Soliveri,Paola, AU - Scarone,Silvio, AU - Gambini,Orsola, Y1 - 2015/04/08/ PY - 2014/12/01/received PY - 2015/03/26/accepted PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2015/10/27/medline SP - 73 EP - 73 JF - BMC psychiatry JO - BMC Psychiatry VL - 15 N2 - BACKGROUND: Capgras delusion is a delusional misidentification syndrome, in which the patient is convinced that someone that is well known to them, usually a close relative, has been replaced by an impostor or double. Although it has been frequently described in psychotic syndromes, including paranoid schizophrenia, over a third of the documented cases of Capgras delusion are observed in patients with organic brain lesions or neurodegenerative disease, including Parkinson's Disease. Variants of Capgras involving animals or inanimate objects have also been described. The etiology of Capgras in Parkinson's remains unclear, but may arise from a combination of factors, such as frontal lobe dysfunction and dopaminergic medication. CASE PRESENTATION: We present the case of a 53-year old right-handed female with Parkinson's disease who developed Capgras delusion during treatment with dopamine agonists and Levodopa/Carbidopa. She became convinced that her pet dogs and the plants in her garden had been substituted by identically looking ones. Our patient was initially treated with Quetiapine, with no improvement, and subsequently treated with Clozapine, which lead to partial regression of her symptoms. Neuropsychological Evaluation showed Mild Cognitive Impairment in Executive Functions. CONCLUSIONS: Given the clinical history, onset and evolution of symptoms we believe our patient's delusion resulted from the overlap of dopaminergic medication and Mild Cognitive Impairment in executive functions. Zoocentric Capgras, the variant we describe, has been rarely described in scientific literature, and we believe it is of interest due to its unusual characteristics. SN - 1471-244X UR - https://www.unboundmedicine.com/medline/citation/25886646/Capgras_delusion_for_animals_and_inanimate_objects_in_Parkinson's_Disease:_a_case_report_ L2 - https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0460-7 DB - PRIME DP - Unbound Medicine ER -