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. 2017 Aug 3;3(4):179-185.
doi: 10.1192/bjpo.bp.117.005041. eCollection 2017 Jul.

Uncovering Capgras delusion using a large-scale medical records database

Vaughan Bell  1 , Caryl Marshall  2 , Zara Kanji  3 , Sam Wilkinson  4 , Peter Halligan  5 , Quinton Deeley  6
Affiliations

Uncovering Capgras delusion using a large-scale medical records database

Vaughan Bell et al. BJPsych Open. .

Abstract

Background: Capgras delusion is scientifically important but most commonly reported as single case studies. Studies analysing large clinical records databases focus on common disorders but none have investigated rare syndromes.

Aims: Identify cases of Capgras delusion and associated psychopathology, demographics, cognitive function and neuropathology in light of existing models.

Method: Combined computational data extraction and qualitative classification using 250 000 case records from South London and Maudsley Clinical Record Interactive Search (CRIS) database.

Results: We identified 84 individuals and extracted diagnosis-matched comparison groups. Capgras was not 'monothematic' in the majority of cases. Most cases involved misidentified family members or close partners but others were misidentified in 25% of cases, contrary to dual-route face recognition models. Neuroimaging provided no evidence for predominantly right hemisphere damage. Individuals were ethnically diverse with a range of psychosis spectrum diagnoses.

Conclusions: Capgras is more diverse than current models assume. Identification of rare syndromes complements existing 'big data' approaches in psychiatry.

Declaration of interests: V.B. is supported by a Wellcome Trust Seed Award in Science (200589/Z/16/Z) and the UCLH NIHR Biomedical Research Centre. S.W. is supported by a Wellcome Trust Strategic Award (WT098455MA). Q.D. has received a grant from King's Health Partners.

Copyright and usage: © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

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Figures

Fig. 1
Fig. 1. Capgras case data extraction procedure. CRIS, Clinical Records Interactive Search.
Fig. 2
Fig. 2. Categories and definitions for case note classification used by independent raters.
Fig. 3
Fig. 3. MMSE score box plot for Capgras cases and comparison samples. Sz, schizophrenia; F28/F29 psychosis; other/unspecified nonorganic psychotic disorders.
See this image and copyright information in PMC

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