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Edelstyn, N. M. J.; Oyebode, F.
doi: 10.1002/(SICI)1099-1166(199901)14:1<48::AID-GPS891>3.0.CO;2-0pmid: N/A
In this article the epidemiology, aetiology, neuroanatomy and neuropsychology of the Capgras syndrome (CS) are reviewed in detail. CS is characterized by the delusional belief that one or a few highly familiar people have been replaced by impostors who are physically very similar to the original/s. The patient acknowledges that the double and known person look alike, but maintains the belief that the significant person, in psychological terms, is absent. CS is relatively rare, occurring predominantly in the context of schizophrenia, and was traditionally considered to have its origins in psychodynamic conflict. More recently, however, it has been estimated that between 25 and 40% of cases are associated with organic disorders, which include dementia, head trauma, epilepsy and cerebrovascular disease. Neuroimaging evidence suggests a link between CS and right hemisphere abnormalities, particularly in the frontal and temporal regions. Neuropsychological research has provided empirical support for these findings, by consistently reporting the presence of impairments in facial processing—an established right hemisphere function. It is likely that the study of this symptom will lead to a greater understanding of the neurological basis of psychotic experiences and may provide a paradigm for how the psychoses should be investigated. Copyright © 1999 John Wiley & Sons, Ltd.
Krasucki, Christopher; Ryan, Pat; Ertan, Turan; Howard, Robert; Lindesay, James; Mann, Anthony
doi: 10.1002/(SICI)1099-1166(199901)14:1<60::AID-GPS893>3.0.CO;2-Gpmid: 10029937
Objective. To develop a shorter version of the Anxiety Disorder Scale (ADS) for use as a rapid screening instrument in primary care. Design. Two‐stage screening design. Primary care attenders aged 65 and over were screened for generalized anxiety in the surgery with the 11‐item generalized anxiety subscale of the ADS (ADS GA), a selected subsample then proceeding to a clinical validation interview. Interventions. None. Main outcome measures. Scores on the ADS GA, non‐hierarchical ICD‐10 caseness for generalized anxiety established by brief clinical interview by an old age psychiatrist. Results. The prevalence rate of generalized anxiety was 16% using the established cutpoint and showed an age‐related decline. A cutpoint of 2–3/11 appeared to give optimal performance in this small sample (sensitivity 85%, specificity 77%, positive predictive value 52%), suggesting that 36% of elderly general practice attenders might be diagnosed as having generalized anxiety. A reduced four‐item version gave a predicted sensitivity of 77%, a specificity of 83% and a positive predictive value of 63% (cutpoint 1–2/4). Conclusions. A four‐item version of the ADS GA, the FEAR (frequency of anxiety; enduring nature of anxiety; alcohol or sedative use; restlessness or fidgeting), has potential as a rapid screening instrument for use in primary care. Copyright © 1999 John Wiley & Sons, Ltd.
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