The question
What happens when recognising a face and believing its identity no longer agree?
Overview
Capgras syndrome describes a delusional belief that a familiar person has been replaced by an identical or nearly identical impostor. It is distinct from simply failing to recognise a face. The reported experience concerns identity and conviction, rather than an actual replacement.
The evidence
A systematic review of published cases gathered 258 cases from 175 papers. It found varied clinical presentations across psychiatric and neurological contexts. A review focused on dementia included 26 studies and described substantial variation in assessment and management.
Interpretation
The relationship between recognition, familiarity and belief is the central research question. No single account should be treated as an explanation for every individual. Recognising someone’s appearance and experiencing an ordinary sense of familiarity are related questions, but they are not interchangeable.
Limits
Published case reports are selected clinical accounts, not a representative population sample. Their numbers cannot establish how common Capgras syndrome is. The dementia review does not establish a universally effective treatment. A reading note cannot assess an individual’s experiences; distressing changes in beliefs or recognition require appropriate clinical assessment.
Source register
Follow the evidence.
Linked research and official information used for this note. Inclusion identifies a source; it does not imply that the source has reviewed this website.
Pandis and colleagues: Capgras’ Delusion, a systematic review ↗Capgras Syndrome in Dementia: systematic review of case studies ↗