Five cases of delusions of pregnancy occurring in women over the age of 64 who had major depressive episodes with mood-congruent delusions are presented. The relation of such delusions to Cotard's syndrome is discussed.
KEY worms-pregnancy delusions; elderly; melancholia; Cotard's syndrome Delusions of pregnancy were described by Esquirol in his treatise Des Maladies Mentales (1 838). They have been described in schizophrenia, erotomania and dementia and have no nosological specificity, but are often associated with affective disorder (Vie and Bobe, 1932;Bourgeois, 1980). Luque and Berrios (1 994) have reported Cotard's syndrome to be frequent in the elderly. In a review of around 200 papers, they identified 100 cases of Cotard's syndrome, 20 of which involved patients over 65 years of age. In order to evaluate the syndrome's 'completeness', they constructed a 'Cotard index' by summing the number of: nihilistic delusions; delusions of hypochondriacal concern; immortality, guilt and damnation; other delusions; and hallucinations. We report five cases of delusions of pregnancy in elderly depressed women (6482 years old) suggesting that this kind of delusion, when occurring in a melancholic state, may be considered to be similar to Cotard's syndrome.