A case report of Capgras syndrome with multiple imposters: a unique presentation of a rare syndrome

Anas Ibn Auf; Afaf Alabdali; Abdulaziz Aljardahi

doi:10.5114/ppn.2026.159807

eISSN: 2720-5371
ISSN: 1230-2813

Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii

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A case report of Capgras syndrome with multiple imposters: a unique presentation of a rare syndrome

Anas Ibn Auf

^{1, 2}

,

Afaf S. Alabdali

¹

,

Abdulaziz N. Aljardahi

¹

Erada and Mental Health Complex, Taif, Saudi Arabia
Department of Psychiatry, Eastern Sudan University for Medical Sciences and Technology, Port Sudan, Sudan

Adv Psychiatry Neurol 2026; 35 (1): 79-82

DOI: https://doi.org/10.5114/ppn.2026.159807

Data publikacji online: 2026/03/04

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Purpose
This case study presents an unusually severe variant of Capgras syndrome involving multiple imposters, which is considered a rare presentation.

Case description
A 37-year-old male with schizophrenia exhibited complex delusional misidentification involving his parents, siblings, and ex-spouse, whom he believed had each been replaced by hundreds of different imposters. These imposters were differentiated by subtle physical and behavioral features. The delusional system extended to include persecutory beliefs involving secret organizations and supernatural entities. This elaborate form of serial substitution, rarely reported in the literature, reflects a highly systematized psychotic process and highlights the breadth of misidentification phenomena. Clinical assessment supported a diagnosis of schizophrenia with prominent delusional misidentification.

Comment
The case adds to the growing recognition of how Capgras syndrome can manifest in atypical and exaggerated forms, raising important questions about the underlying neurocognitive and affective mechanisms driving these beliefs. Awareness of such presentations is crucial for accurate diagnosis and conceptual understanding.

słowa kluczowe:

A case report of Capgras syndrome with multiple imposters: a unique presentation of a rare syndrome

Anas Ibn Auf 1, 2 , Afaf S. Alabdali 1 , Abdulaziz N. Aljardahi 1

schizophrenia, delusions, psychotic disorders, Capgras syndrome, delusional misidentification

Anas Ibn Auf

^{1, 2}

,

Afaf S. Alabdali

¹

,

Abdulaziz N. Aljardahi

¹