Currell Emily A, Werbeloff Nomi, Hayes Joseph F, Bell Vaughan
a Division of Psychiatry , University College London (UCL) , London , UK.
b Institute of Psychiatry, Psychology and Neuroscience , King's College London , London , UK.
Cogn Neuropsychiatry. 2019 Mar;24(2):123-134. doi: 10.1080/13546805.2019.1584098. Epub 2019 Feb 22.
Although important to cognitive neuropsychiatry and theories of delusions, Capgras delusion has largely been reported in single case studies. Bell et al. [2017. Uncovering Capgras delusion using a large scale medical records database. British Journal of Psychiatry Open, 3(4), 179-185] previously deployed computational and clinical case identification on a large-scale medical records database to report a case series of 84 individuals with Capgras delusion. We replicated this approach on a new database from a different mental health service provider while additionally examining instances of violence, given previous claims that Capgras is a forensic risk.
We identified 34 additional cases of Capgras. Delusion phenomenology, clinical characteristics, and presence of lesions detected by neuroimaging were extracted.
Although most cases involved misidentification of family members or partners, a notable minority (20.6%) included the misidentification of others. Capgras typically did not present as a monothematic delusion. Few cases had identifiable lesions with no evidence of right-hemisphere bias. There was no evidence of physical violence associated with Capgras.
Findings closely replicate Bell et al. (2017). The majority of Capgras delusion phenomenology conforms to the "dual route" model although a significant minority of cases cannot be explained by this framework.
尽管卡普格拉妄想对认知神经精神病学和妄想理论很重要,但大多是在单病例研究中报道。贝尔等人[2017年。使用大规模医疗记录数据库揭示卡普格拉妄想。《英国精神病学杂志·开放版》,3(4),179 - 185]此前在一个大规模医疗记录数据库上运用计算和临床病例识别方法,报告了一个包含84例卡普格拉妄想患者的病例系列。我们在来自另一家心理健康服务提供商的新数据库上重复了这种方法,同时鉴于之前有关卡普格拉是一种法医风险的说法,额外研究了暴力事件实例。
我们又识别出34例卡普格拉病例。提取了妄想现象学、临床特征以及神经影像学检测到的病变情况。
虽然大多数病例涉及对家庭成员或伴侣的错误识别,但有相当一部分(20.6%)包括对其他人的错误识别。卡普格拉妄想通常并非以单主题妄想形式出现。很少有病例有可识别的病变,且没有右半球偏向的证据。没有证据表明卡普格拉妄想与身体暴力有关。
研究结果与贝尔等人(2017年)的研究结果密切相符。大多数卡普格拉妄想现象学符合“双路径”模型,尽管有相当一部分病例无法用该框架解释。