Psychopathology (MRCP) Flashcards
Description and categorization of abnormal experiences as reported by the
patient and observed from his behaviour is known as
A. Experimental psychopathology
B. Descriptive psychopathology
C. Explanatory psychopathology
D. Philosophical psychiatry
E. None of the above
B. Psychopathology is the systematic study of abnormal experience, cognition, and
behaviour. It consists of two major divisions –
1. explanatory psychopathology, which attempts to explain causative factors through theory
generation or experimental construction; hence explanatory psychopathology includes
experimental (e.g. behaviourism) and theoretical (e.g. psychoanalysis) subtypes;
2. descriptive psychopathology, which precisely describes and categorizes abnormal experiences
as reported by the patient and observed from his behaviour.
A 55-year-old man with chronic schizophrenia resists any passive limb
movements attempted during a neurological examination, in spite of being
asked not to do so. Which of the following symptom is he exhibiting?
A. Obstruction
B. Negativism
C. Automatic obedience
D. Waxy fl exibility
E. Ambitendency
B. This patient is exhibiting a catatonic symptom called negativism. Patients with negativism
resist or oppose all passive movements attempted by the examiner. A mild form of such
resistance is called Gegenhalten or opposition. In extreme forms it is called negativism, where
apparently motiveless resistance to all interference is found. Negativism can be a frustrating
symptom, especially for carers involved in offering nursing assistance to the patient. The catatonic
symptom of blocking or obstruction (or Sperrung) refers to a phenomenon similar to thought
blocking but occurs while carrying out motor acts. A patient with obstruction suddenly stops a
motor act for no reason, without any warning. This may be demonstrated by asking the patient to
move a part of his body; the movement is generally well begun, but then stops halfway without
any indication. In ambitendency the patient makes a series of tentative, opposing, alternate
movements that do not reach the intended goal. This becomes evident when the patient is asked
to carry out a motor act, for example asking the patient to show his tongue will elicit repeated
protrusion and retraction of tongue as if the patient is undecided about showing his tongue
According to Jaspers, the most important component of psychiatric assessment is A. Empathy B. Humour C. Judgement D. Reasoning E. Common sense
A. While humour may facilitate the process of clinical interview on certain occasions, it is
not a necessary component of descriptive psychopathology. There are two essential components
of descriptive psychopathology: (1) the observation of behaviour; and (2) the empathic
assessment of subjective experience. The latter was referred to by Jaspers as phenomenology and
implies that the patient is able to introspect and describe his internal experiences and the doctor
recognizes and understands the description. To describe a phenomenon, it is important to
appreciate the phenomenon from the beholder’s point of view. This attempt to ‘feel like how your
patient might feel’ is very different from feeling sorry or pity for your patient. The former is called
empathy while the latter is called sympathy. Empathy is an essential component to learn further
about the pathological processes taking place in a patient.
The concept of symptoms assessed by descriptive psychopathology has
both form and content as its components. Which of the following, with
regard to this statement, is true?
A. Form provides suffi cient information for management
B. Form provides suffi cient information for severity
C. Form is more important than content
D. Form provides suffi cient information for diagnosis
E. Content is more important than form
D. The patient usually presents with loss or impairment of functions, the reasons for which
will reveal the contents of the patient’s thoughts and feelings. Form is the technical term (e.g.
phobia, obsession, or delusion) used to identify a recurring pattern of experience or behaviour
and so helps in diagnosing the psychiatric disorder. Content is essential for decisions about the
management of the patient and family (suicidal content, admission, etc.), and is an important
aspect of the severity of the disorder. A symptom described using descriptive psychopathology
has both form and content as equally important components. The same content can occur in
different forms, for example the content ‘I’m too fat’ can occur as an obsession, delusion,
overvalued idea, or even hallucination
A patient is experiencing increased brightness and acuity of visual objects.
Intense perceptions occur in all of the following EXCEPT
A. Migraine
B. Hallucinogens
C. Mania
D. Delirium
E. Depression
E. Stimulus may be perceived as corresponding object but not as accurate as the real object.
This is a perceptual error (sensory distortion), and can be associated with changes in physical
properties, for example size, shape, intensity, and colour. In depression and hypoactive delirium
there is dulled perception. Intense perceptions can occur in mania, hyperactive delirium, and
drug-induced states (hallucinogens). Hyperacusis is especially seen in migraine and alcohol
hangover.
A 35-year-old lady complains of changes in the shape of objects perceived. She is having diffi culties in perceiving the symmetry of objects. This symptom is called A. Dysmegalopsia B. Micropsia C. Macropsia D. Lilliputian hallucinations E. Pareidolia
A. A perceptual error associated with changes in shape of objects, especially with loss of
symmetry, is called dysmegalopsia. The objects can shrink in size (micropsia) or enlarge
(macropsia). These are usually organic and could be related to ictal (parietal) or ocular pathology
(accommodation errors – paralysed accommodation can cause micropsia). They are also rarely
seen in acute schizophrenia. Hallucinogens (e.g. mescaline) can also change the colour of
perceived objects or make components of an object (e.g. body parts) be seen detached in space.
A 12-year-old boy, at a school anniversary celebration, vividly describes what martians may look like. Which of the following is true about this imagery? The imagery is A. A perception B. A fantasy C. A pseudohallucination D. An illusion E. None of the above
B. Imagery is not a perception because there is no stimulus involved and no object
perceived; it is essentially a fantasy. Imagery refers to images produced voluntarily with complete
insight that they are a mental phenomena and not of external origin. Imageries lack the ‘objective’
quality of hallucinations and normal sense perceptions
An 8-year-old boy is frightened to be alone at home. He starts seeing monsters out of wind moving through window curtains. Which of the following symptoms is he experiencing? A. Pareidolia B. Completion illusion C. Eidetic imagery D. Affect illusion E. Hallucination
D. There are three major types of illusions: in affect illusion the prevailing emotional state
leads to misperceptions, for example a depressed patient reading ‘deed’ as ‘dead’, a boy frightened
of the dark seeing monsters from innocuous shadows. Pareidolia refers to perceiving formed
objects from ambiguous stimuli, for example seeing cars in the clouds. It is common in delirium,
especially in children. They are often playful – not characteristic of any psychotic illness.
Completion illusion is due to inattention; stimulus that does not form a complete object might be
perceived to be complete, for example CCOK is read as COOK. Eidetic imagery is considered to
be a special ability of memory wherein visual images are drawn from memory accurately, at will
and described as if being perceived currently. This is not a perceptual distortion but closely linked
to mental imagery and it is often noted in children.
A 19-year-old man sees his new girlfriend’s face from the shapes of clouds. This perception will A. Intensify on paying attention B. Cannot be dismissed voluntarily C. Arises from unambiguous stimuli D. Associated with intense affect change E. Associated with loss of insight
A. Pareidolia refers to perceiving formed objects from ambiguous stimuli, for example seeing
faces in a fi re or hidden messages when records are played in reverse. It is coloured by prevailing
emotion and not entirely due to inattention or affective change; fantasy and imagery play a part in
addition to actual sense perception. On paying extra effort the object intensifi es and does not
disappear. Pareidolia is common in febrile delirium, especially in children, and also in hallucinogen
use. They are under voluntary control and often playful. Occurrence of pareidolia is not
characteristic of any psychotic illness.
A 35-year-old lady reports hearing voices in her head. Which of the
following differences between hallucination and pseudohallucination is true?
A. In true hallucinations insight is often retained
B. True hallucinations are often identifi ed to be originating from self
C. True hallucinations occur in subjective space
D. True hallucinations are sought in other modalities by the patient
E. True hallucinations cannot occur in two modalities simultaneously
D. Hallucinations have several important qualities which are essential in differentiating them
from other mental phenomena. Hallucinations take place at the same time and in the same space
as other perceptions, for example ‘an angel is standing in the corner of my room’. This is different
from fantasy or imagery which takes place in a subjective space. They are experienced as
sensations – not as thoughts – in contrast to obsessional images. The percept has all the qualities
of a real world object , that is a patient when hallucinating believes that the percept can be
experienced in other modalities too, like a real object which can be seen, felt, smelt, and heard.
Pseudohallucinations are defi ned variously. The term is used to describe hallucination-like
experiences with retained insight (so it is not sought in other modalities of perception). It is also
used to describe hallucination-like experiences that take place in a subjective space, for example
‘a voice inside my head’.
Which one of the following is an elementary hallucination?
A. Flashes of light
B. Visions of small mice in a minutiae
C. Voices repeating the word ‘go’
D. Voices speaking in an unknown language
E. None of the above
A. Elementary hallucinations are unstructured hallucinations that are seen in acute organic
states. They are composed of sounds or fl ashes without being fully formed. Elementary
hallucinations can precede development of fully formed hallucinations, especially in alcoholic
hallucinosis. The fl ashes of lights are also called phosphenes. Words such as ‘go’ are meaningful
and so cannot be a part of elementary hallucination.
Which of the following is NOT a common feature of schizophrenic auditory hallucinations? A. Being multiple B. Male voice C. Speaks in one’s mother tongue D. Often continuously present E. Has a different accent
D. Phonemes are any auditory hallucinations that occur as human voices. Schizophrenic
phonemes are usually multiple voices. The voices may or may not be recognizable. These voices
are usually male with a different accent but speaking in one’s mother tongue. Schizophrenic
hallucinations are usually episodic – almost never continuous. Continuous, non-stop hallucinations
should make one suspect the veracity of the reported experience.
Which of the following can cause visual hallucinations? A. Occipital lobe tumours B. Postconcussion states C. Hepatic failure D. Dementia E. All of the above
E. Occipital lobe tumours, postconcussional states, epileptic twilight state, hepatic failure
(any toxic delirium), and dementia are some of the known causes of visual hallucinations. In fact,
nearly 30% of old-age psychiatric referrals have visual hallucinations. Solvent sniffi ng and
hallucinogens can cause elementary visual hallucinations such as light fl ashes. In dementia of Lewy
body type visual hallucinations are a prominent feature.
An 80-year-old lady with normal consciousness experiences vivid,
distinct, colourful images of Mickey Mouse in her living room. On physical
examination one must look for which of the following signs?
A. Visual acuity
B. Glasgow coma scale
C. Plantar refl ex
D. Knee jerk
E. Cranial nerves
A. Elderly patients having normal consciousness and no brain pathology but with reduced
visual acuity due to ocular problems experience vivid, distinct, usually well-coloured
hallucinations. This is known by the eponym Charles Bonnet syndrome. Paradoxically these
perceptions are clear and colourful in contrast to real sensation, which is blurred due to eye
disease. These hallucinations are mostly in the form of humans, or at times animals and cartoons.
These objects usually show movement, and can be voluntarily controlled to an extent as they
disappear on closing the eyes. Insight about unreality is usually preserved – though they may
evoke emotions, including fear and joy. About one-third of Charles Bonnet hallucinations are
elementary, unformed hallucinations. Usually these hallucinations are located in external space
A patient withdrawing from alcohol sees small Chinese soldiers marching on his carpet. This phenomenon is called A. Micropsia B. Macropsia C. Lilliputian hallucination D. Pseudohallucination E. Affective illusion
C. Lilliputian hallucinations can occur in visual or haptic mode – they usually involve seeing
tiny people or animals (or feeling diminutive insects crawling if haptic) and are seen in delirium
tremens. Unlike other organic visual hallucinations, lilliputian hallucinations can be accompanied
by pleasure (though this is often intermingled with terror). These are not the same as micropsia.
Micropsia is a perceptual distortion but not a hallucination as there is a stimulus which is
perceived to be erroneously small. Perception of small objects in the absence of such stimuli is a
lilliputian hallucination.
A 22-year-old college student reports a peculiar visual disturbance that
causes images to persist even after their corresponding stimulus has ceased.
Which of the following symptoms best suits the above description?
A. Pareidolia
B. Palinopsia
C. Autoscopy
D. Imagery
E. Formication
B. Palinopsia (palin for ‘again’ and opsia for ‘seeing’). is a visual disturbance that causes images
to persist even after their corresponding stimulus has ceased. It is seen in LSD use, migraine,
occipital epilepsy, and head trauma. It is similar to afterimage but colour inversion (usually
shadows or distorted colours) noted in afterimages is conspicuously absent. Formication (formic
acid – from ants) is a special type of haptic hallucination. It is often an unpleasant sensation of
little animals or insects crawling under the skin, seen in delirium tremens and cocaine intoxication
A 54-year-old man who is living at a psychiatric rehabilitation home
complains of seeing his own image outside his body. Which of the following
is the commonest psychiatric cause of this phenomenon?
A. Schizophrenia
B. Temporal lobe epilepsy
C. Depression
D. Mania
E. Dementia
C. Autoscopic hallucinations are the visual experience of seeing oneself. It is seen
predominantly in males compared to females at a ratio of 2:1. Impaired consciousness is a
common accompaniment and depression is the commonest psychiatric cause of autoscopy. They
are also called phantom mirror images and may take the form of pseudohallucinations.
Schizophrenia (where autoscopic experience is usually pseudohallucinatory), TLE, and parietal
lesions (organic states more likely to have true hallucinations) are also implicated. In negative
autoscopy one looks into a mirror and sees no image at all.
Which of the following drugs on withdrawal produce disturbed proprioceptive perceptions? A. Cannabis B. Amphetamines C. LSD D. Benzodiazepines E. Nicotine
D. Chronic benzodiazepine use leads to the development of dependence, with a
characteristic withdrawal syndrome that presents with anxiety and agitation, insomnia, tremor,
depersonalization, and, if severe, can lead to seizures and delirium. Kinaesthetic or proprioceptive
hallucinations refer to joint or muscle sense, often linked to bizarre somatic delusions.
Kinaesthetic hallucinations are seen in benzodiazepine withdrawal and alcohol intoxication
A patient, whose right arm was amputated following a crush injury, suffers
from recurrent, tactile sensations arising out of the lost limb. Which of the
following symptoms is this description classifi ed as?
A. Hallucination
B. Pseudohallucination
C. Body image disturbance
D. Somatization
E. Delusion
C. The common experience of phantom limb is a body image disturbance and not a
hallucination; though it is in external space, it does not satisfy other qualities of hallucination and
patients are usually aware of unreality. It is a body image disturbance with a neurological basis
Which of the following is an extracampine hallucination?
A. A 45-year-old man hears voices coming from the South Pole
B. A 33-year-old man hears a voice coming from his left knee
C. A 56-year-old lady sees a devil’s tail hanging on a hook
D. A 31-year-old man sees an angel without a face
E. None of the above
A. Extracampine hallucinations are hallucinations that occur outside the normal fi eld of
perception, for example images seen behind your back, under your sternum, or hearing voices
from Inverness, etc. (if you are not living in Inverness, of course!). They occur in schizophrenia,
epilepsy, and also in hypnagogic hallucinations of healthy people – so they are not diagnostically
important.
A patient can hear voices when ever the noise of water running through a tap is heard. This is called A. Refl ex hallucination B. Synaesthesia C. Functional hallucination D. Extracampine hallucination E. Reverse hallucination
C. In functional hallucinations an external stimulus provokes a hallucination, and both
hallucination and stimulus are in same modality but individually perceived, for example voices
heard simultaneously when ever the noise of water running through a kitchen tap is heard. They
are not illusions, as the stimulus is perceived appropriately (noise of water), but in addition there
is another perception (voices) without an appropriate object. If hallucinations in one modality are
provoked refl exively by stimulus in another modality, for example seeing an angel when ever
listening to music, then this is called refl ex hallucination. The phenomenon of perceiving a
stimulus of one modality in a different modality (may be single or multiple modalities) is called
synaesthesia, for example tasting the music, hearing colours, and smelling voices.
The phenomenon of perceiving a stimulus of one modality in a different modality is called A. Refl ex hallucination B. Synaesthesia C. Functional hallucination D. Extracampine hallucination E. Reverse hallucination
B. Synaesthesia is defi ned broadly as a mingling of the senses. People with the condition may
see a colour when they look at a number or hear a tone when they see a colour. It is not a
hallucination as the perception comes from an appropriate stimulus. The original stimulus is
simultaneously perceived in appropriate modality in addition to the cross modality perception
(syn – joint, simultaneous).
An 18-year-old girl is able to perceive colours when she listens to cello
music. Which of the following is incorrect regarding synaesthesia?
A. It is more common in females
B. It is often occurs in multiple members of a family
C. Colour–number synaesthesia is the most common type.
D. It is related to defective synaptic pruning
E. It is a form of hallucination
E. Synaesthesia is common in females (4:1), runs in families, and colour–number
synaesthesia is the most common form. It is thought to be due to extensive cross-wiring between
multimodal association regions in some people, probably due to failed selective pruning. It is not
a hallucination.
Which one of the following is NOT matched correctly?
A. Form of thought – loosening of association
B. Content of thought – persecutory belief
C. Stream of thought – poverty of speech
D. Form of thought – obsessions
E. Form of thought – circumstantiality
D. The pathology of thought can be divided into content (What is being ‘thought about’?),
form (In what manner (or shape) is the thought present?), and stream or fl ow (How is it being
thought about?). Disordered thought content is seen as delusions, for example persecutory
themes, obsessions, or preoccupations. Overvalued idea is also a disorder of thought content.
Disordered stream of thought is seen as poverty of thought, pressure of speech, and crowding of
thoughts. Disordered form of thought, as seen in schizophrenia and other psychotic disorders,
refers to a set of various alterations in the thinking process – loosening of associations,
metonyms, tangentiality, and circumstantiality to name a few. As an analogy, ‘thought’ can be
considered to be a box of packed fruits bought in the supermarket. Form is equivalent to the
shape of the box (e.g. rectangular plastic box), content is equivalent to the type of fruit (e.g.
oranges or peaches) and stream is equivalent to the number of fruits in the box (e.g. 6 or 12).
Which one of the following is more common in manic rather than schizophrenic speech disturbance? A. Clanging B. Derailment C. Thought blocking D. Tangentiality E. Poverty of content of speech
A. Of all thought disorders classifi ed by Andreasen, clanging and fl ight are more common in
mania while derailment (loosening) and thought blocking (and to some extent tangentiality and
poverty of content of speech) are seen often in schizophrenia – other items were not thought to
be specifi c for a particular psychiatric condition.
A 66-year-old man tends to repeat the same answer for all subsequent questions. This is pathognomonic of A. Schizophrenia B. Organic brain damage C. Mixed affective state D. Conversion disorder E. Stuttering
B. In perseveration the thought process tends to persist beyond a point at which they are
relevant. Perseveration generally occurs with clouded consciousness and is considered
pathognomonic of organic brain disease. Perseveration can be demonstrated verbally or through
repetitive motor activity. It can be seen in schizophrenia too. Stuttering is due to motor speech
in-coordination and does not involve the mechanism of perseveration.
Obsessions are intrusive and repetitive mental phenomenon. In which of the following forms can an obsession occur? A. Thoughts B. Words C. Images D. Impulses E. All of the above
E. Obsessions usually evoke distress and anxiety and are not pleasurable by defi nition. They
are unwanted, intrusive, repetitive, senseless thoughts experienced by patients as troublesome
and resisted. Obsessions can be thoughts, words, impulses, or images. They usually occur in
themes of sex, religion, violence, safety, and grooming (e.g. orderliness, washing out germs, etc.).
Obsessions are appreciated to be against values and ideals of self. Which of
the following terms corresponds to this description?
A. Ego-dystonic
B. Ego-syntonic
C. Ego-ideal
D. Ego-neutral
E. Ego-ridden
A. In obsessions, though the appearance of the thoughts themselves is appreciated to be
beyond a patient’s control, they are not claimed to be due to an external agency. Obsessions are
regarded to be one’s own mind’s product but ego-dystonic – against one’s values and needs.
Often during the course of OCD, primary obsessions fade while compulsions dominate the
clinical picture; some compulsions can be mental behaviours such as praying, counting, etc.
Passivity phenomena can occur as any of the following EXCEPT A. Thought insertion B. Thought withdrawal C. Thought broadcasting D. Thought blocking E. None of the above
D. A subjective disturbance in thinking seen in schizophrenia is described as passivity, which
can occur in the form of thought insertion, thought withdrawal, and thought broadcasting. These
are fi rst-rank symptoms of schizophrenia. Thought blocking is not a passivity or alienation
phenomenon.
Which of the following is NOT a fi rst-rank symptom of schizophrenia? A. Thought echo B. Somatic hallucinations C. Delusional perception D. Thought withdrawal E. Made volition
B. The first-rank symptoms are:
Three hallucinations:
Audible thoughts (thought echo)
Voices heard arguing (3rd person)
Voices heard commenting on one’s actions (running commentary)
Three ‘made’ phenomena:
Made affect (someone controlling the mood/ affect)
Made volition (someone controlling the action – usually a completed act)
Made impulse (someone controlling the desire to act – not completed act but the drive. If the action
has been carried out, then the patient admits to ownership of the act, not the impulse behind it)
Three thought phenomena: (experiences themselves are more important than later explanations
of how a patient interprets them)
Thought withdrawal
Thought insertion (external agency inserting thoughts into the patient )
Thought broadcast (also called thought diffusion – as if in a television broadcast, everyone
comes to know about the patient’s thinking as and when the patient thinks – refers to loss
of privacy of thoughts. Contrast with referential delusion – ‘people act as if they know what I
am thinking’)
Two isolated symptoms:
Delusional perception
Experience of sensations on the body caused by external agency (somatic passivity)
Somatic hallucinations are NOT fi rst rank symptoms unless there is a delusional elaboration and
attribution of the origin of sensations to an external agency (passivity).
Which of the following statements with regard to fi rst-rank symptoms is
incorrect?
A. It is a comprehensive list of schizophrenic symptoms
B. It emphasizes form not content
C. It has clearly identifi able features
D. They are seen more often in schizophrenia than other psychosis
E. They are not essential for diagnosis
A. Kurt Schneider proposed an empirical cluster of symptoms, one or more of which, in the
absence of evidence of organic processes, can be used as positive evidence for schizophrenia.
These symptoms are not comprehensive features of schizophrenia; they are clearly identifiable,
frequently occurring, and occur more often in schizophrenia than any other disorder. First-rank
symptoms emphasize form rather than content, for example the fact that one’s thoughts are
heard as echo of voices is more important than the actual content of the voices; this increases
cross-cultural reliability, although variations exist. First-rank symptoms have some diagnostic but
no prognostic importance in schizophrenia
A patient suffers from an osteoarthritic knee pain, but he believes it is
caused by ‘the leader of a cybernetic extermination gang’ in an attempt to
robotize him. Which of the following symptoms is he exhibiting?
A. Somatic hallucination
B. Somatic passivity
C. Somatization
D. Body image disturbance
E. Delusional perception
B. Somatic passivity refers to experience of sensations in one’s body believed to be caused
by some external agency. It can follow a normal sensation, such an osteoarthritic knee pain,
ascribed to be caused by an external agency, as in this case.
Various dimensions of delusional experience include all EXCEPT A. Distress B. Loss of insight C. Preoccupation D. Conviction E. Callousness
E. Kendler (1983) has listed the dimensions of delusional experiences (also incorporated in
the Maudsley Assessment of Delusions Scale) – conviction, extension (to various spheres of life),
disorganization (or organization–internal consistency and systematization), bizarreness (especially
in schizophrenia), and pressure (includes preoccupation and distress). Acting on delusion, seeking
evidence, and lack of insight can be added as other qualities. These various dimensions exist in a
continuum with normal beliefs
Which of the following is NOT a primary delusion? A. Delusional mood B. Delusional memory C. Delusional perception D. Delusional intuitions E. Delusional misinterpretation
E. Primary delusions are defi ned in two different ways: (1) Jaspers’ concept of primary
delusions is that they are un-understandable and cannot be reduced further to any other mental
experiences; and (2) primary delusions are also thought of as the fi rst abnormal mental
experience to occur in schizophrenia prodrome (primary as per temporal sequence). Often both
of these are true – primary delusions are not only irreducible but also precede other mental
phenomena. The four types of primary delusions are: (1) delusional mood; (2) delusional
perception; (3) delusional memory; and (4) autochthonous delusion (often simply referred to as a
primary delusion).
A 44-year-old man is taken into police custody for harassing his wife. He
is convinced that she is having an affair but in fact, she isn’t. Which of the
following disorders cannot explain the above presentation?
A. Alcohol dependence
B. Misidentification syndrome
C. Delusional disorder
D. Schizophrenia
E. Dementia
B. Morbid jealousy can occur in various forms – delusion, overvalued idea, in depression,
and in anxiety states; it is not a misidentification syndrome. It was first described by Ey. It is
common in alcoholics. It has a potential for violence, especially against the perceived rival for
one’s partner, and can occur among cohabitants and homosexual couples too.
A 65-year-old woman believes that she is already dead. Similar delusions are
reported in which of the following diseases?
A. Schizophrenia
B. Depressive psychosis
C. Late-onset depression
D. Organic disorders
E. All of the above
E. Cotard’s syndrome is severe depression with nihilistic and hypochondriacal delusions
tinged with grandiosity and a negative attitude. It is not related to delusional misidentifi cation.
Cotard’s syndrome is seen in schizophrenia, though more commonly in depressive psychosis. It is
generally seen in elderly people and is also reported in organic lesions and migraine
