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Heroin Addiction and Related Clinical Problems: 2018, 20, N1 (pages: 7 - 12)

Capgras Syndrome in a Heroin Addict. A Case Study

Lovrecic M., and Lovrecic B.

Summary: Background: Capgras syndrome is an extremely rare clinical manifestation. A Capgras delusion can be associated with psychiatric or neurological disorders, with drug therapy or toxicities, metabolic conditions, or nutritional deficiencies, and it is difficult to diagnose. In addition, substance use can mimic or mask symptoms of other psychiatric disorders and can lead to the misdiagnosis or underdiagnosis of other psychiatric conditions. Case Report: A drug user with a history of several compulsory hospital admissions to psychiatric hospitals due to violence and physical attacks on others, failed to comply with prescribed treatment in the community, was restarted in directly observed daily therapy combined with stabilization methadone treatment and antipsychotic treatment. Conclusions: Although heroin addiction is a treatable condition, both heroin addiction and methadone treatment are still strongly stigmatized by the lay public, general opinion, patients, patients' family members, and those with professional qualifications such as health professionals. This is the first published case of Capgras syndrome in a heroin addict where daily directly supervised methadone treatment helped the drug user to adhere to outpatient antipsychotic treatment integrated with methadone in such a way as to improve compliance and make it possible to manage conditions involving severe risks.