A 33 year old male who was travelling by a flight staed fighting with one of the air hostesses. The man alleged that the airhostess is actually his ‘wife’ and she has changed her face, so that she cant be identified. This history is consistent with-
**Core Concept**
The patient's behavior can be attributed to a condition known as Capgras delusion, a type of delusional misidentification syndrome where an individual believes that a friend, family member, or spouse has been replaced by an identical imposter. This condition is often associated with schizophrenia, paranoid personality disorder, or other psychiatric conditions.
**Why the Correct Answer is Right**
The patient's belief that the airhostess has changed her face to avoid identification is a classic example of Capgras delusion. This delusion is thought to arise from a dysfunction in the brain's neural networks, particularly in the right hemisphere, which is responsible for recognizing and processing facial features. The patient may also experience feelings of paranoia and mistrust, leading to aggressive behavior. In this case, the patient's history is consistent with Capgras delusion, as he is convinced that the airhostess has been replaced by an imposter.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the patient's condition. While the patient may exhibit paranoid behavior, it is not sufficient to diagnose a full-blown paranoid personality disorder.
**Option B:** This option is incorrect because it does not account for the patient's delusional thinking. The patient's belief that the airhostess has changed her face is a delusional thought, not a hallucination.
**Option C:** This option is incorrect because it does not describe the patient's specific symptoms. While the patient may exhibit aggressive behavior, it is not sufficient to diagnose a full-blown schizophrenia spectrum disorder.
**Clinical Pearl / High-Yield Fact**
Capgras delusion is often associated with a lesion in the right hemisphere of the brain, particularly in the right inferior parietal lobule. This area is responsible for processing facial features and recognizing familiar individuals.
**Correct Answer: D. Capgras delusion.**