Strange Tales of Crime: Case 1 -The down after the high
WARNING — The following cases have descriptions of crime that some readers may find disturbing.
Case 1
Our first case follows a 28-year old male, with no prior history of mental illness. The man was presented to health services after he had attempted to murder (unsuccessfully) a neighbour.
Upon examination the man was found to be suffering with a wide variety of delusions such as the belief that he was a world-famous musician. Another belief was that his grandfather was an infamous terrorist. Though these delusions were potent the patient did not present with hallucinations.
The patient reported that he believed his true parents had been killed several years before and they had been replaced by imposters this is a condition known as Capgras Syndrome.
There was a description the patient gave that indicated a clear homicidal intent towards his parents who he no longer recognised.
The patient had been taking cannabis for a number of years, and it was important to rule out organic causes of Capgras syndrome. The final diagnosis was Capgras Syndrome perhaps caused by cannabis use.
Treatment
Treatment involved Lorazepram as well as Clozapine and several other interventions. Unfortunately one month later there seemed to be no decrease in the desire of the man to commit parricide. The regimen was adjusted and this time the Capgras delusion was eliminated.
The above case along with specific MRI findings can be accessed here: https://assets.cureus.com/uploads/case_report/pdf/83724/20220119-6061-67z6dq.pdf
Discussion
In terms of sheer bizarreness, Capgras syndrome has to be one of the strangest neuropsychological issues.
Capgras Syndrome is an illness whereby an individual maintains the belief that those closest to them family/friends have been replaced by some imposter or malevolent force.
For cases such as these it is fairly simple to say that the individual should escape penal consequences since he was acting under the oppression of a powerful delusion. However in other cases the question of ‘guilt’ vs ‘innocence’ is a lot harder to answer. When the law is so binary, there is very little room for nuance.
In later cases and articles we will explore some of these issues of culpability.
History
Joseph Capgras first described this unusual condition in 1923 in a 53-year old woman who had become convinced that an imposter had taken over her husband, even more strangely that she herself had also been replaced.
There have been other cases where Capgras has led someone to kill his father and this will be discussed in the next story.
More info on the history of Capgras can be found here: https://europepmc.org/article/MED/34033319/NBK430685#free-full-text
