Capgras Syndrome in Dementia: A Systematic Review of Case Studies.

Charikleia Margariti, Margareta-Theodora Mircea
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Abstract

Background: In an ageing population, dementia has become an imminent healthcare emergency. Capgras syndrome, the most common delusion of misidentification (DMS), is frequently found alongside dementia. Previous research showed that Capgras syndrome has significant negative effects on people living with dementia and their carers due to its complex presentation and impact on their lives. This qualitative systematic review explores the evidence base of the effective management and treatment of Capgras syndrome in dementia.

Aims: As per our knowledge, this is the first systematic review exploring the symptomatology of Capgras syndrome across different types of dementia. Additionally, it aims to identify the treatments used and their efficacy.

Methods: Four databases (EMBASE, MEDLINE, PsycINFO, and CINHAL) were screened in March, 2023. Twenty-six studies met the inclusion criteria and were included in the review. Thematic analysis was performed to explore and synthesise the qualitative findings of the studies.

Results: Three conceptual themes were identified: diagnostic tools, Capgras syndrome symptomatology, and Capgras syndrome treatment. Results showed that Capgras syndrome in dementia is not diagnosed and treated in a standardised manner. Following the pharmacological intervention, 28% of cases showed resolution of symptoms, and another 28% experienced improvement. However, 7% of cases reported worsening symptoms, and 10.7% experienced no change. While some patients had positive outcomes with specific medications, others either did not respond or experienced a deterioration of their condition.

Conclusion: The results highlight that there is no single treatment approach for Capgras syndrome in people living with dementia. This underscores the need for person-centred care, where treatment is tailored to individual needs. The review also reveals a heavy reliance on antipsychotic medications and a noticeable lack of psychosocial interventions. Given the limited benefits and significant risks associated with antipsychotics, future research should prioritise developing and testing psychosocial approaches. Additionally, establishing standardised diagnostic criteria and consistent outcome measures for Capgras syndrome in dementia is crucial for evaluating treatment effectiveness and improving care.

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痴呆症中的卡普格拉斯综合征:病例研究的系统回顾。
背景:随着人口老龄化的加剧,痴呆症已成为迫在眉睫的紧急医疗问题。卡普格拉斯综合征是最常见的错认妄想(DMS),经常与痴呆症同时出现。以往的研究表明,由于卡普格拉斯综合征的表现形式复杂,对痴呆症患者及其照顾者的生活造成了严重的负面影响。本定性系统综述探讨了有效管理和治疗痴呆症患者卡普格拉斯综合征的证据基础。目的:据我们所知,这是第一篇探讨不同类型痴呆症患者卡普格拉斯综合征症状的系统综述。此外,它还旨在确定所采用的治疗方法及其疗效:方法:2023 年 3 月筛选了四个数据库(EMBASE、MEDLINE、PsycINFO 和 CINHAL)。有 26 项研究符合纳入标准并被纳入综述。对这些研究的定性结果进行了主题分析和综合:结果:确定了三个概念性主题:诊断工具、卡普拉综合征症状和卡普拉综合征治疗。结果显示,痴呆症患者的卡普格拉斯综合征并没有得到标准化的诊断和治疗。在接受药物干预后,28%的病例症状得到缓解,另有28%的病例症状得到改善。然而,7%的病例报告症状恶化,10.7%的病例症状没有变化。虽然一些患者在接受特定药物治疗后取得了积极的效果,但其他患者要么没有反应,要么病情恶化:结论:研究结果表明,对于痴呆症患者的卡普格拉斯综合征,没有一种单一的治疗方法。结论:研究结果表明,对于痴呆症患者的卡普格拉斯综合征,并没有一种单一的治疗方法,这就强调了以人为本的护理的必要性,即根据个人需求进行治疗。综述还揭示了对抗抑郁药物的严重依赖以及心理干预的明显缺乏。鉴于抗精神病药物的益处有限且存在重大风险,未来的研究应优先开发和测试社会心理疗法。此外,为痴呆症患者的卡普格拉斯综合征建立标准化诊断标准和一致的结果测量方法,对于评估治疗效果和改善护理至关重要。
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