Abstract
Catherine Mackirdy, Tauranga, New Zealand:
The correspondents [1] adopt an extraordinarily arrogant tone, which perhaps illustrates the perennial truth that any discussion of race is likely to provoke powerful emotion. The attempt to recast me as a racist carries a certain irony, which could only be fully appreciated if I supplied a photograph of this department, and my extended family.
Dr Shepherd and I were fully aware that Capgras syndrome is not a category in DSM-IV. Are Rae and Frampton suggesting that it is therefore not interesting, and that the world of the psychiatrist should begin and end with this classification system? I actually agree with Professor Kendall's view that impostor delusions are symptoms, and of no particular diagnostic significance. In a similar way to pathological jealousy, impostor delusions can occur in a variety of clinical settings. Whereas the former condition carries a well-established strong association with dangerousness, our reading of the literature showed, as we said in the article, that some authors have noted an association between impostor delusions and dangerousness. This observation has had nothing to do with race, nor does it ignore the fact that many cases with Capgras delusions are quite harmless.
Our article was not an epidemiological study, nor did it pretend to be. We reported an observation which we found interesting, and gave the reader some background information, which we also thought would be of interest. It would be a great pity, in my opinion, if clinicians became so blinded by science that they were deterred from reporting interesting facts.
I think the real take-home message should be that these cases are probably indicative of the fact that Maori in this country suffer poorer mental health, despite our current best efforts. This poses a challenge for all New Zealand mental health services.