ABSTRACT | PDF
Case Report II
Schizophrenia with Capgras’ syndrome
Atmesh Kumar
Postgraduate Trainee of Psychiatry
Silchar Medical College and Hospital
Twenty six years old unmarried Hindu male was brought by his father. The reason for psychiatric consultation was senseless talking and occasional aggressive behaviour for one month. He was arrogant and assaultive towards family members. He sometimes refused to accept his name as called by the family members and raised question about him being part of the same family. He was repeatedly talking that his father, mother, brothers and sisters were not real and were originally bought in a mela (fair) by paying some minimal amount of money. They were valueless to him as he could again buy them if needed. He was irritable when his father was present by his bedside. He kept talking that somebody who was exact double of his father had come out of the mirror. This happened when his original father was looking in the mirror. He did not believe the person claiming to be his father and suspected his evil designs and intentions. When confronted he explained that actually by behaving sweet and simple his so-called father was trying to steal the money and the money printing machine left in his name by Mahatma Gandhi. Patient also showed restlessness, irritability and spitting. He seldom made proper eye contact and rapport could not be established. Most of the time he maintained an expressionless face and emotional blunting was present. His ‘senseless’ talking mostly represented his bizarre thoughts like –
faces of people present around him looked like suns and moons and so many of them moving near him made him restless, angry and irritable;
invisible, boring and haughty teachers were forcibly taking his bedside classes constantly and were trying to teach him something which he neither liked nor wanted to listen;
whenever he felt abdominal discomfort and distention, he was sure that Basuki naag (the snake over which Lord Vishnu lies) had entered his stomach to disturb him and his spitting was an effort to get rid of its venom. He even tried to convince the physicians and the people present there that they could see the snake running out of the room as soon as he mentioned its name and secret;
an invisible machine present near him was continuously monitoring and controlling the people around him so they were being pulled to his bedside. This explanation was given when the attending physicians and ward staffs had gathered around him during rounds.
During the initial interview after telling one or two relevant answers, his thoughts always used to wander away in unknown directions. He was irritable and angry so interview was taken in brief, repetitive session.
He had no insight into his illness and described himself as healthy person. The patient had history of psychiatric consultation for similar symptoms six months back. Treatment was stopped within few days as he got suspicious and refused to accept medicines.
He was diagnosed with paranoid schizophrenia, period of observation too short (F20.09).
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