Edelstyn N M, Oyebode F
University Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham, UK.
Int J Geriatr Psychiatry. 1999 Jan;14(1):48-59.
In this article the epidemiology, aetiology, neuroanatomy and neuropsychology of the Capgras syndrome (CS) are reviewed in detail. CS is characterized by the delusional belief that one or a few highly familiar people have been replaced by impostors who are physically very similar to the original/s. The patient acknowledges that the double and known person look alike, but maintains the belief that the significant person, in psychological terms, is absent. CS is relatively rare, occurring predominantly in the context of schizophrenia, and was traditionally considered to have its origins in psychodynamic conflict. More recently, however, it has been estimated that between 25 and 40% of cases are associated with organic disorders, which include dementia, head trauma, epilepsy and cerebrovascular disease. Neuroimaging evidence suggests a link between CS and right hemisphere abnormalities, particularly in the frontal and temporal regions. Neuropsychological research has provided empirical support for these findings, by consistently reporting the presence of impairments in facial processing--an established right hemisphere function. It is likely that the study of this symptom will lead to a greater understanding of the neurological basis of psychotic experiences and may provide a paradigm for how the psychoses should be investigated.
本文详细综述了卡普格拉综合征（CS）的流行病学、病因学、神经解剖学和神经心理学。CS的特征是存在妄想信念，即认为一个或几个非常熟悉的人被外貌与原人极为相似的冒名顶替者所取代。患者承认替身与熟人长得相像，但坚信从心理层面来讲，重要的那个人并不在场。CS相对罕见，主要发生于精神分裂症背景下，传统上认为其源于心理动力学冲突。然而，最近据估计，25%至40%的病例与器质性疾病有关，这些疾病包括痴呆、头部外伤、癫痫和脑血管疾病。神经影像学证据表明CS与右半球异常之间存在联系，尤其是额叶和颞叶区域。神经心理学研究通过持续报告面部加工（一种已确定的右半球功能）存在损伤，为这些发现提供了实证支持。对这种症状的研究可能会使人们对精神病体验的神经学基础有更深入的理解，并可能为精神病的研究提供一个范例。
