Treating the Chicken Woman

Fascinating case history about a woman briefly convinced she was a chicken.

Posted Oct 06, 2020

Clinical zoanthropy, or the delusional belief of becoming an animal, has a long and colourful history. 

For example, the Book of Daniel in the Bible mentions King Nebuchadnezzar II who was cursed by God for his pride. As a result, he “was driven from men and did eat grass as oxen” for seven years until his sanity was eventually restored. The very word lycanthropy stems from the Greek myth of King Lycaon who was transformed into a wolf by the gods for his crimes. 

Throughout the centuries, there have been numerous examples recorded, usually in the form of myths and legends which may have helped foster the belief in werewolves and shapeshifters around the world. Still, actual cases of clinical zoanthropy as reported in the medical and psychological literature tend to be much rarer. From 1850 to the present day, for example, there have been less than sixty case histories involving people believing themselves to be or acting like or behaving like, any kind of animal: whether it be a dog, lion, tiger, crocodile, snake, or bee. 

This is what makes a new case history published in the Belgian Journal of Psychiatry (Tijdschrift voor Psychiatrie), so memorable. Written by a team of Belgian psychiatrists at the Universitair Psychiatrisch Centrum in the Belgian city of Leuven, the case history described their patient, a 54-year-old woman who had been admitted to hospital with the bizarre belief that she was, well, a chicken.   

The patient's brother had brought her to the hospital emergency ward after reporting that he found her in their garden showing bizarre behaviour, including flapping her arms and making strange crowing noises. She had no relevant medical history, no history of substance use, and aside from a family history of depression, showed no mental health issues except for being treated for grief following the death of a parent 10 years earlier. Though she had been experiencing depression for several months prior to her episode, apparently brought on by problems at work, no real clues could be found about what was responsible for her strange condition.

As the authors related in their paper, "Clinically, we saw a lady who perspired profusely, trembled, blew up her cheeks, and… seemed to imitate a chicken, [making noises] like clucking, cackling, and crowing like a rooster" according to the translated text. "After about 10 minutes she seemed to tighten her muscles for a few seconds, her face turned red and for a short time, she didn't react. These symptoms repeated themselves at intervals of a few minutes [and her] consciousness was fluctuating," with the patient "disoriented in time and space."

Shortly after they began examining the patient, she experienced a generalized epileptic seizure with evidence of cyanosis and foam on the lips and, after being treated with medication, fell into a deep sleep for several hours. Once she was awake, her condition appeared completely normal with absolutely no sign of her previous delusion and with all medical signs having returned to normal.  She also had almost complete amnesia concerning what happened over the previous few days.   

Brain imaging and EEG testing showed no signs of any abnormalities that could have explained her bizarre delusion. She was discharged from the hospital and her condition was followed for several months with no sign of seizures or other symptoms. After a year of recovery, she eventually returned to work and is reportedly doing fine.

While reported cases of clinical zoanthropy remain rare, lead author Dr. Athena Beckers suggested in a recent media interview that it may often go unrecognized by psychiatrists. "We suspect, however, that the delusion is not always noticed: [If] the patient shows bizarre behaviour or makes animal sounds, it is probably often catalogued under the general term 'psychosis,'" she said.   

According to a 2014 literature review, the most common psychiatric diagnoses given in these cases are schizophrenia (25%), psychotic depression (23.2%), bipolar disorder (19.6%), and psychotic disorder (12.5%) though cases of zoanthropy due to the influence of hallucinogenic drugs or other recreational substances have also been reported.

But Beckers stressed that neurological conditions, including epilepsy, should also be considered as well. "I myself have only seen this type of delusion once, but I… heard anecdotal stories from other patients whose family member, for example with schizophrenia, sometimes thought he was a cow [during]… a psychosis," she said. "After the publication of my article I was also contacted by someone who told me they had experienced the same thing 30 years ago—he thought he was a chicken. "I think it's a good thing that we psychiatrists are aware of the fact that clinical zoanthropy exists and may require additional research," she observed.

Even though a case history about a woman who briefly thought she was a chicken doesn't seem that memorable, especially compared to other case histories, including one involving a patient who was convinced he was turning into a werewolf (spoiler alert, he wasn't). Still, clinical zoanthropy is a fascinating example of the kind of depersonalization syndrome that occasionally crops up in the clinical literature. Similar syndromes include Cotard’s syndrome, a rare condition marked by the false belief that the person or their body parts are dead, dying, or don’t exist, and Capgras delusion where the affected person believes that a spouse or close family member has been replaced with an impostor. 

Whether these delusions occur as the result of some underlying psychiatric or neurological condition or because of substance use, they still help highlight the comments made by Belgian neuropsychiatrist Georges Otte in a recent media interview: "The interface between neurology and psychiatry… is a fertile meadow on which many crops thrive. But it is in the darkest corners of psychosis that one finds the most bizarre and also rarest excesses."

References

A. Beckers, R. van Buggenhout, E. Vrieze (2020).  Klinische zoantropie; een vrouw met de zeldzame waan een dier te zijn  (Clinical zoanthropy; a woman with the rare delusion of being an animal) TIJDSCHRIFT VOOR PSYCHIATRIE, 62 (2020) 7, 582 - 586