Capgras Syndrome: A 21-Year Retrospective Evaluation in a Psychiatric Inpatient Setting

Öz

Amaç: Capgras sendromu (CS), bireyin tanıdık bir kişinin aynı görünüme sahip bir başkasıyla değiştirildiğine inanmasıyla karakterize edilen sanrısal bir yanlış tanıma sendromudur. Bu çalışmada, üçüncü basamak bir psikiyatri yatan hasta kliniğinde CS'nin görülme sıklığını belirlemek ve sendromla ilişkili sosyodemografik, klinik ve fenomenolojik özellikleri; özellikle hedef alınan kişi, sanrısal içerik ve saldırgan davranış ilişkisi açısından ikincil ve keşifsel analizlerle incelemek amaçlanmıştır. Gereç ve Yöntem: Ocak 2004 - Ocak 2025 tarihleri arasında hastanede yatarak tedavi edilen tüm erişkin hastaların dosyaları geriye dönük olarak incelenmiştir. CS tanısı önceden belirlenmiş fenomenolojik ölçütler doğrultusunda operasyonelleştirilmiş ve iki psikiyatrist tarafından bağımsız inceleme ile doğrulanmıştır. Klinik ve sosyodemografik değişkenler, hedef alınan kişiler, sanrısal temalar, varsanılar, saldırgan davranış ve nörogörüntüleme bulguları kaydedilmiştir. Klinik ve sosyodemografik özelliklere yönelik tanımlayıcı ve karşılaştırmalı analizlerin yanı sıra, hedef alınan kişi, sanrısal içerik ve saldırgan davranış arasındaki ilişkileri incelemek amacıyla keşifsel analizler yapılmıştır. Değişkenler arasındaki ilişkiler uygun parametrik olmayan ve kesin testlerle analiz edilmiş; etki büyüklükleri (Phi, Cramer's V) hesaplanmış ve seçilmiş anlamlı olmayan bulgular için post-hoc güç analizleri yapılmıştır. Bulgular: Toplam 1328 hastanın 28’inde (%2.1) CS saptanmıştır. En sık eşlik eden tanı şizofrenidir (%75.0). En sık hedef alınan kişiler ebeveynler (%39.3) olup, en baskın sanrısal içerik perseküsyon sanrılarıdır (%85.7). Olguların %39.2’sinde saldırgan davranış öyküsü mevcuttur. Saldırgan davranış ile tanı, cinsiyet, ailede psikiyatrik hastalık öyküsü veya hedef kişi arasında istatistiksel olarak anlamlı ilişki saptanmamıştır (tüm p>0.050). Bazı alt grup analizlerinde orta düzey etki büyüklükleri gözlenmiş olmakla birlikte, post-hoc güç analizleri istatistiksel gücün sınırlı olduğunu göstermiştir. Sonuç: CS, tanısal, kişilerarası ve fenomenolojik özelliklerle karakterize heterojen bir klinik tablodur. Hedef alınan kişi, sanrısal içerik ve saldırgan davranış arasında betimleyici örüntüler gözlenmiş olsa da istatistiksel olarak güçlü ilişkiler gösterilememiştir. Bu gözlemsel örüntülerin daha geniş örneklemlerde araştırılması yararlı olabilir. Bulgular, klinik değerlendirme ve risk analizinde fenomenolojik ve kişilerarası boyutların dikkate alınmasının önemini vurgulamaktadır. Anahtar Kelimeler: Capgras sendromu, Fenomenoloji, Saldırgan davranış, Sanrısal yanlış tanıma, Şizofreni.

Anahtar Kelimeler

• Capgras sendromu
• sanrısal yanlış tanıma
• şizofreni
• saldırgan davranış
• fenomenoloji

Etik Beyan

Çalışma için etik onay, Gazi Üniversitesi Klinik Araştırma Etik Kurulu'ndan 25 Kasım 2025 tarihinde alınmıştır (Onay No: 2025/1936; Belge Tarihi ve Numarası: 25.11.2025-E.1392815) ve tüm işlemler Helsinki Bildirgesi'ne uygun olarak yürütülmüştür.

Capgras Syndrome: A 21-Year Retrospective Evaluation in a Psychiatric Inpatient Setting

Öz

Objective: Capgras syndrome (CS) is a delusional misidentification syndrome characterized by the belief that a familiar person has been replaced by an identical-looking impostor. This study aimed to determine the prevalence of CS in a tertiary psychiatric inpatient unit and examine its associated sociodemographic, clinical, and phenomenological characteristics. Secondary exploratory analyses focused on target identity, delusional content, and aggressive behavior. Materials and Methods: Medical records of all adult patients hospitalized between January 2004 and January 2025 were retrospectively reviewed. The diagnosis of CS was defined using predefined phenomenological criteria and confirmed through independent review by two psychiatrists. Clinical and sociodemographic variables, target identity, delusional themes, hallucinations, aggressive behavior, and neuroimaging findings were extracted. In addition to descriptive and comparative analyses of clinical and sociodemographic characteristics, exploratory analyses examined associations among target identity, delusional content, and aggressive behavior. Associations between variables were examined using nonparametric and exact tests, and effect sizes (Phi, Cramer’s V) were calculated. Post-hoc power analyses were conducted for selected non-significant findings. Results: Among 1,328 inpatients, 28 patients (2.1%) met the criteria for CS. Schizophrenia was the most common associated diagnosis (75.0%). Parents were the most frequently targeted individuals (39.3%), and persecutory delusions were the predominant delusional theme (85.7%). Aggressive behavior was documented in 39.2% of cases. No statistically significant associations were found between aggressive behavior and diagnosis, sex, family history, or target identity (all p > 0.050). Although moderate effect sizes were observed in certain subgroup analyses (e.g., sex and parental targeting; schizophrenia subtype and aggression), post-hoc power analyses indicated limited statistical power. Conclusion: CS represents a heterogeneous clinical condition characterized by diagnostic, relational, and phenomenological factors. Although descriptive patterns involving target identity, delusional content, and aggression were observed, statistically robust associations were not demonstrated. These observational patterns may warrant further investigation in larger samples. These findings underscore the importance of incorporating phenomenological and interpersonal dimensions into clinical assessment and risk evaluation. Keywords: Aggressive behavior, Capgras syndrome, Delusional misidentification, Schizophrenia, Phenomenology.

Anahtar Kelimeler

• Capgras syndrome
• delusional misidentification
• schizophrenia
• aggressive behavior
• phenomenology

Etik Beyan

Ethical approval for the study was obtained from the Gazi University Clinical Research Ethics Committee on November 25, 2025 (Approval No: 2025/1936; Document Date and Number: 25.11.2025-E.1392815), and all procedures were conducted in accordance with the Declaration of Helsinki.

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