Towards a unified, yet pluralistic, account of Capgras' delusion.

Abstract

Introduction: In this paper, we present a new way of thinking about what is going on in cases of Capgras delusion which is a more varied presentation than represented in the literature. We do this by reflecting on the fundamental nature of identification, and then draw some lessons from this for understanding misidentification in general and Capgras delusion cases in particular. What emerges, through the conceptual tool of "mental files", is a unified, yet pluralistic, account of delusional misidentification of the Capgras type. In other words, it allows us to see the delusion for what it really is and to understand what all such instances have in common (hence unified), while also accommodating the great heterogeneity in cause, aetiology and clinical presentation (hence pluralistic).

Methods: We apply the innovation of mental files and the idea that misidentification is fundamentally about file mismanagement to provide a better understanding of Capgras delusion.

Results: We demonstrate how the mental files account allows us to more plausibly accommodate the variety of clinical cases that more traditional approaches fail to account for. It also points us in the direction of as-yet-undeveloped aetiological models.

Conclusions: The mental files approach provides us with a unified, yet flexible, framework, and as such furthers our understanding of misidentification and the Capgras delusion.