Stompe Thomas, Schanda Hans
Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Neuropsychiatr. 2013;27(1):38-46. doi: 10.1007/s40211-012-0046-2. Epub 2013 Jan 10.
The Cotard-Syndrome (CS), the belief of being dead, was described for the first time in 1880. Since then it met the interest not only of psychopathologists but also of philosophers. With a few exceptions, the literature is mainly restricted to case reports of anxious-depressive, demented or paranoid patients. It was the aim of our study to investigate the prevalence and the psychopathological context of the CS.
We analyzed the Austrian data (N = 346) of the International Study of Psychotic Symptoms in Schizophrenia.
A CS could be diagnosed in three cases (0.87%). In all of them, CS developed on the basis of nihilistic-hypochondriac delusions and a progressive loss of energy. Two patients bridged the logical inconsistencies between obviously being alive and the belief of being dead by visual illusions, the third patient, however, by locating himself in an intermediate region between this world and the afterworld.
On the one hand the CS can be considered as a special manifestation of the topic of death in schizophrenic delusions, on the other as a nihilistic delusional identity. Without doubt, this uncommon and bizarre psychotic phenomenon will be an object of interest for general psychopathology as well as for the philosophy of mind also in future.
科塔尔综合征（CS），即坚信自己已死亡，于1880年首次被描述。从那时起，它不仅引起了精神病理学家的兴趣，也引起了哲学家的兴趣。除了少数例外，相关文献主要局限于焦虑抑郁、痴呆或偏执患者的病例报告。我们研究的目的是调查科塔尔综合征的患病率及其精神病理学背景。
我们分析了精神分裂症国际精神病症状研究中的奥地利数据（N = 346）。
三例（0.87%）可诊断为科塔尔综合征。在所有病例中，科塔尔综合征都是在虚无主义疑病妄想和逐渐丧失精力的基础上发展而来的。两名患者通过视觉错觉弥合了明显活着与坚信自己已死亡之间的逻辑矛盾，然而，第三名患者则是通过将自己定位在这个世界与来世之间的中间区域来解决这一矛盾。
一方面，科塔尔综合征可被视为精神分裂症妄想中死亡主题的一种特殊表现形式，另一方面，可被视为一种虚无主义妄想性身份认同。毫无疑问，这种罕见且怪异的精神病现象在未来仍将是普通精神病理学以及心灵哲学感兴趣的对象。
