Cases That Test Your Skills

When your brother becomes a ‘stranger’

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References

Continued treatment: Gradual change

Day by day Ms. D’s mania subsides gradually, though she still fears that a stranger posing as her brother is stalking her. She talks about her brother less frequently, though she is clearly holding fast to her delusional beliefs.

We discharge Ms. D after 10 days. Although her symptoms have not resolved, she is markedly less manic and less agitated than at admission. We arrange treatment with outpatient psychiatry. She does not follow up with her original psychiatrist and is lost to follow-up.

Related resources

  • PsychNet-UK. Disorder information sheet: Capgras (delusion) syndrome. www.psychnet-uk.com/dsm_iv/capgras_syndrome.htm.
  • Bourget D, Whitehurst L. Capgras syndrome: a review of the neurophysiological correlates and presenting clinical features in cases involving physical violence. Can J Psychiatry 2004;49:719-25. Available at: www.cpa-apc.org/Publications/Archives/CJP/2004/november/bourget.asp.
  • Barton JJ. Disorders of face perception and recognition. Neurol Clin 2003;21:521-48.
  • Lewis S. Brain imaging in a case of Capgras’ syndrome. Br J Psychiatry 1987;150:117-21.
  • Christodoulou GN. The syndrome of Capgras. Br J Psychiatry 1977;130:556-64.
Drug brand names
  • Haloperidol • Haldol
  • Lithium • Eskalith, others
  • Quetiapine • Seroquel
Disclosures

The authors report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

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