The key feature is the presence of a nihilistic delusion related to the patient's own body, soul, life or existence. Beliefs may include:
(1) that the patient's body is dead and should be buried
(2) that the patient is pregnant (when not)
(3) that the patient has no "self" or soul with a body that is an empty shell
(4) that the person is immortal
(5) that one or more organs have disappeared or been destroyed
(6) that the patient is paralyzed and unable to move
Psychological problems that may precede or exist concurrently include:
(1) depression with psychotic break
(2) severe anxiety
(3) hypochondriacal or other delusions
(4) guilt or despair
(5) bipolar personality
A common finding is negativism, in which the person does the opposite of what a normal person might do.
