{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:22Z","timestamp":1790983102136,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>Adolescent first-episode psychosis may combine schizophrenia-spectrum, affective, trauma-related, and developmental features, and Capgras syndrome is uncommon in this age group. We report a confidentially de-identified case of a 16-year-old female high-school student with no previous psychiatric admission or known substance use who developed severe insomnia, reduced self-care, external auditory hallucinations, paranoid and referential ideation, Capgras-type misidentification of her father, and a multithemed bizarre delusional system after cumulative psychosocial stressors including earthquake-related displacement, relocation, school transition, peer exclusion, appearance-related mockery, and family-school conflict. Laboratory tests, brain magnetic resonance imaging, electroencephalography, substance screening, and child neurology consultation were unrevealing. DSM-5-TR schizophreniform disorder was the initial working diagnosis; bipolar disorder with psychotic features, schizoaffective disorder, brief psychotic disorder, trauma-related or dissociative phenomena, substance\/medication-induced psychosis, autoimmune encephalitis, and temporal lobe epilepsy were considered. Risperidone- and olanzapine-based treatment produced partial but insufficient improvement. Clozapine was initiated at admission week 8 and titrated to 175 mg\/day over approximately 4 weeks. Marked improvement was observed by week 2 of clozapine-centered treatment and remission by week 4. At admission week 12, the Clinical Global Impression-Severity score was 1, the Positive and Negative Syndrome Scale score was 45, and the Young Mania Rating Scale score was 4. At 8-month follow-up, the patient remained clinically stable on clozapine 175 mg\/day, and the diagnosis was maintained as schizophrenia because the longitudinal course exceeded 6 months. This case highlights the diagnostic complexity of adolescent-onset psychosis with Capgras syndrome, the need to distinguish contextual stressors from primary etiology, and the cautious, monitored consideration of clozapine when severe schizophrenia-spectrum psychosis shows insufficient response to standard antipsychotic trials.<\/jats:p>","DOI":"10.3389\/fpsyt.2026.1887119","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:34:28Z","timestamp":1785216868000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Severe adolescent-onset schizophrenia with Capgras syndrome and remission during clozapine-centered treatment after earthquake-related displacement and peer victimization"],"prefix":"10.3389","volume":"17","author":[{"given":"Mustafa","family":"\u00c7obaner","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, University of Health Sciences, Trabzon Kanuni Training and Research Hospital","place":["Trabzon, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Evren","family":"Tufan","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Bolu Abant \u0130zzet Baysal University Faculty of Medicine","place":["Bolu, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"B1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jclinepi.2013.08.003","article-title":"The CARE guidelines: consensus-based clinical case report guideline development","volume":"67","author":"Gagnier","year":"2014","journal-title":"J Clin Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.14088","article-title":"Annual research review: Psychosis in children and adolescents: key updates from the past 2 decades on psychotic disorders, psychotic experiences, and psychosis risk","volume":"66","author":"Kelleher","year":"2025","journal-title":"J Child Psychol Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.02.008","article-title":"Practice parameter for the assessment and treatment of children and adolescents with schizophrenia","volume":"52","author":"McClellan","year":"2013","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B6","volume-title":"Psychosis and Schizophrenia in Children and Young People: Recognition and Management. 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