Sequential Cotard and Capgras delusions

• Published in: British journal of clinical psychology Vol. 32 ( Pt 3); p. 345
• Main Authors: Wright, S, Young, A W, Hellawell, D J
• Format: Journal Article
• Language: English
• Published: England 01-09-1993
• Subjects: Adult; Brain - physiopathology; Capgras Syndrome - complications; Capgras Syndrome - diagnosis; Capgras Syndrome - drug therapy; Capgras Syndrome - physiopathology; Carbamazepine - therapeutic use; Chlorpromazine - administration & dosage; Chlorpromazine - therapeutic use; Delusions - complications; Delusions - diagnosis; Delusions - drug therapy; Delusions - physiopathology; Depressive Disorder - complications; Depressive Disorder - diagnosis; Depressive Disorder - drug therapy; Depressive Disorder - physiopathology; Electroencephalography; Humans; Male; Memory Disorders - complications; Memory Disorders - physiopathology; Perphenazine - administration & dosage; Perphenazine - therapeutic use; Psychiatric Status Rating Scales
• ISSN: 0144-6657
• DOI: 10.1111/j.2044-8260.1993.tb01065.x

We report sequential Cotard and Capgras delusions in the same patient, KH, and offer a simple hypothesis to account for this link. The Cotard delusion occurred when KH was depressed and the Capgras delusion arose in the context of persecutory delusions. We suggest that the Cotard and Capgras delusions reflect different interpretations of similar anomalous experiences, and that the persecutory delusions and suspiciousness that are often noted in Capgras cases contribute to the patients' mistaking a change in themselves for a change in others ('they are impostors'), whereas people who are depressed exaggerate the negative effects of the same change whilst correctly attributing it to themselves ('I am dead'). This explains why there might be an underlying similarity between delusions which are phenomenally distinct.