SEQUENTIAL COTARD AND CAPGRAS DELUSIONS

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