Cotard’s syndrome has ?
a) Persecutory delusions
b) Religious delusions
c) Nihilistic delusions
d) Hypochondrical delusions
Correct Answer - C
Ans. is ‘c’ i.e., Nihilistic delusions
Types of delsions
Based on the contents of delusions, they are divided into :-
- Persecutory delusions (paranoid) : - The patient feels that he is
being persecuted against. There is false belief that one is being
harmed, threatened, cheated, poisoned, harassed or spied on or is a
victim of conspiracy to damage his reputation. The supposed
persecutor of the patient may be people in the environment (e.g.,
members of family, neighbours, former friend) or may be political or
religious groups. These delusions occur in schizophrenia (especially
paranoid), severe affective disorders (sever mania or severe
depression), and organic brain syndrome. This is the most common
type of delusion. Delusion of persecution may occur in the context of
primary delusional experiences, auditory hallucinations, bodily
hallucinations or experiences of passivity. - Grandiose delusion (expansive delusions) : - False belief that one is
exceptionally powerful, talented or important. These delusions seen
most commonly in mania, However, can also occur in schizophrenia
and organic states. - Delusions of reference : - False belief that certain objects, people or
events have intense personal significance and refer specifically to
one self, e.g., believing that a television news reader is talking
directly about oneself, or people walking on the road are talking
about him. These delusions are seen in schizophrenia, mania and
organic states. - Religious delusions : - False belief pertaining to a religious theme,
often grandiose in nature, e.g., believing that one is a special
messenger from God. These delusions are seen in schizophrenia. - Delusions of love (erotomania) : - False belief that another person is
in love with one (commoner in woman). In one form, termed de
clerambault sydrome, a woman (usually) believes that a man,
frequently older and of higher status, is in love with her. - Delusion of infidility (morbid jealousy, othello syndrome :- False
belief that one’s lover has been unfaithful. These are seen in
schizophrenia, alcohol related psychosis, organic states. - Delusion of misidentification : - a) Capgras syndrome (Delusion of
double) : - Belief that a familiar person has been replaced by an
exact double i.e. an impostor. b) Fregoli syndrome : - Belief that a
complete stranger is actually a familiar person already known to one. - Delusion of self accusation or guilt : - False feeling of remorse of
guilt. It occur in Depression. - Nihilistic delusions : - False belief that oneself, others or the world is
non-existent or about to end. There are pessimistic ideas that the
patient’s career is finished, he is about to die, world is doomed.
These occurs in severe depression. If nihilistic delusions are
accompanied by ideas concerning bodily function failure, e.g.,
putrefaction of intestines, etc., the syndrome is called COTARD’s
SYNDROME. - Hypochondriacal delusions : - False belief about one’s health,
patient wrongly believes that he has severe medical illness, contrary
to the all medical evidences. It is seen in depression. - Delusion of infestations : - False belief that one is infested with small
but visible organisms. As a monosymptomatic delusional disorder
this is called EKBOM SYNDROME. It is seen in acute confusional
state (due to drugs or alcohol withdrawal), in schizophrenia, in
dementing illness, and as delusional eloboration of tactile
hallucinatory experiences (secondary to formication). - Delusion of control : - Belief that his actions, impulses or thoughts
are controlled by an outside agency and accordingly called as made
action, made impulse or made affect. Also called somatic passivity
experiences (passivity phenomenon). Commonly seen in
schizophrenia.
13. Delusions concerning possession of thoughts - Patients with
delusions about possession of thoughts may lose the conviction that
their thoughts are their own. Most commonly seen in schizophrenia.
Delusions of thought insertion - thoughts have been implanted by an
outside agency.
Delusions of thought withdrawal - thoughts are being taken out of
their mind. This is usually accompanied by “thought block”.
Delusions of thought broadcast - unspoken thoughts are known to
other people through radio, telepathy or in some other way.