Among the patients with Kapgra syndrome, two main types of false-delusional recognition are fixed: some claim that the double is next to them (they see it, it is touchable), while others claim that their double is invisible (they fix only the consequences of supposedly committed actions) . Such substitutions can concern even their pets (cats, dogs).
Patients may argue that the replacement concerns their pet (cat).
I type - a false-perverted form of recognition of a group of persons. It is divided into positive and negative recognition of twins. False perception extends not to one person, but to a group of people.
With a negative perception of twins, the patient claims that all the relatives around him are replaced by completely different personalities, skillfully disguised as relatives. The relatives were replaced by robots or aliens, only external similarity remained. This is constantly sought confirmation and proof (drawing a make-up, similar clothes). Patients constantly find facts that distinguish true relatives, familiar from twins: facial features, gait, eye color, etc.
Unshakable belief in the existence of doubles makes the patient suspicious and aggressive. It seems to him that twins are a threat, they want to harm or kill him. The patient's aggression is explained by the constant psychological stress and anticipation of the danger coming from all sides.
Perverted positive recognition can concern completely unfamiliar strangers. The patient claims that for a very long time they know, they are disguised as familiar friends and relatives.
In the illusory-delirious form of false recognition, patients become aggressive and dangerous. Perceiving wary "doubles" they may want to change places "replaced" with "right" people. Aggressive behavior is based on the desire to put an end to the understudy by killing them. Patients are difficult to remain calm when the danger is on all sides.
II type is an illusory-delusional form of not perceiving oneself, and the lack of self-identification of one's personality. As well as type I has a negative and positive options. The patient proves to others that all his actions and unseemly acts are not committed by himself, but by his double or "duplicating twin." The patient himself has no relation to any events that occurred - in all his fault is the exact copy.
Such a state of mind as the Kapra syndrome lasts from a few hours to a week or more.
One of the most significant provoking factors is a burdened history of anamnesis (childhood spent in a troubled family, past traumas of the head). The prerequisites for the emergence of the Kapgra syndrome are: diagnosis of schizophrenia, TBI, female alcoholism, alcohol delirium, brain surgery, senile dementia, twilight consciousness. The patient begins to express his own assumptions and suspicions about the substitution of a group of persons or himself. An unnerving suspicion, inability to identify familiar and unfamiliar faces, delusions about substitutions of people should serve as alarming moments.