Psychosis and Capgras delusions in a patient diagnosed with Cogan’s syndrome

doi:10.15761/ccrr.1000103

Abstract

Highlights

Vincent is a 39-year-old Hispanic American gentleman who was admitted to our acute inpatient service on a legal hold as a danger to self, danger to others as well as being gravely disabled
Vincent had one previous admission to our facility approximately 10months prior to this admission. He was admitted on a legal hold as being a danger to others
He had become aggressive with family members, stating that he worked for the CIA and that he was a friend of the governor’s

Summary

Clinical presentation

Vincent is a 39-year-old Hispanic American gentleman who was admitted to our acute inpatient service on a legal hold as a danger to self, danger to others as well as being gravely disabled. The patient’s brother reports that Vincent had become convinced that family members had been substituted by “intruders.” Vincent was not convinced that neither his mother, nor his brother were “real” and had been substituted by imposters We observed this quite dramatically during a family meeting. Vincent had one previous admission to our facility approximately 10months prior to this admission He was admitted on a legal hold as being a danger to others. Vincent did not have a prior history of mental health problems His difficulties began in August of 2010 when he experienced pain in his eyes, blurred vision and photophobia. In January of 2011, a specialty referral to ophthalmology was made which further confirmed the diagnosis of Cogan’s syndrome based on the typical findings of keratitis and posterior synechiae

MRI and CT scan of the brain

Diagnostic considerations for our patient Vincent

Capgras delusion

Findings

Discussion