Berrios G E, Luque R
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, UK.
Compr Psychiatry. 1995 May-Jun;36(3):218-23. doi: 10.1016/0010-440x(95)90085-a.
This report offers an account of the historical construction of Cotard's syndrome showing that by délire des négations the French author meant a subtype of depressive illness. Subsequent debate led first to the belief that it was just a collection of symptoms associated with agitated depression (anxious melancholia) or general paralysis, and later to the view that it might after all constitute a separate entity. At the present moment, and impervious to the fact that the French term délire means far more than "delusion," some authors use Cotard's syndrome to refer to the belief of being dead and suggest that such a delusion might have a specific brain location. From the clinical and evolutionary perspective, it is unclear why a delusion should merit, simply because of its "nihilistic" content, a special brain location or presage chronicity. It is suggested here that before neurobiologic speculation starts, efforts should be made to map out the clinical features and correlations of the délire des négations.
本报告阐述了科塔尔综合征的历史构建，表明法国作者所说的“否定性谵妄”指的是抑郁症的一种亚型。随后的争论首先导致人们认为它只是与激越性抑郁（焦虑性忧郁症）或全身麻痹相关的一组症状，后来又有人认为它可能终究构成一个独立的实体。目前，一些作者不顾法语术语“谵妄”的含义远不止“妄想”这一事实，用科塔尔综合征来指代认为自己已死的信念，并认为这种妄想可能有特定的脑区定位。从临床和进化的角度来看，尚不清楚为什么一种妄想仅仅因为其“虚无主义”内容就应该有一个特殊的脑区定位或预示着慢性病程。这里建议在开始进行神经生物学推测之前，应努力梳理出否定性谵妄的临床特征及其相关性。
