Abstract
Jules Cotard described, in 1880, the case of a patient characterized by delusions of negation, immortality, and guilt as well as melancholic anxiety among other clinical features. Later this constellation of symptoms was given the eponym Cotard's syndrome, going through a series of theoretical vicissitudes, considering itself currently as just the presence of nihilistic delusions. The presentation of the complete clinical features described by Cotard is a rare occurrence, especially in the context of schizophrenia. Here we present the case of a 50-year-old male patient with schizophrenia who developed Cotard's syndrome. The patient was treated with aripiprazole, showing improvement after two weeks of treatment. A review of the literature is performed about this case.
Highlights
On June 28, 1880, Jules Cotard gave a lecture at the Societe Medico-Psychologique entitled Du delire hypocondriaque dans une forme grave de la melancolie anxieuse, in which he described the case of a 43-year-old woman who claimed to have no brain, nerves, stomach, or soul and whose belief was that neither God or the devil existed, avoiding the need to eat and existing eternally until she was burnt [1, 2]
Cotard explained that the delire hypocondriaque resulted from a “. . .delusional interpretation of the pathological sensations experienced by patients suffering from common anxious melancholia” [2]
He wrote that the delire hypocondriaque happened when the delire des negations had been established: “I propose the name of delusions of negation to assign the condition of patients. . . in which the negative disposition has reached its highest level. . . have no head, nor stomach, some even have no body; if they are shown any object, a flower, a rose, they reply: it is not a flower, it is not a rose
Summary
On June 28, 1880, Jules Cotard gave a lecture at the Societe Medico-Psychologique entitled Du delire hypocondriaque dans une forme grave de la melancolie anxieuse, in which he described the case of a 43-year-old woman who claimed to have no brain, nerves, stomach, or soul and whose belief was that neither God or the devil existed, avoiding the need to eat and existing eternally until she was burnt [1, 2]. . .delusional interpretation of the pathological sensations experienced by patients suffering from common anxious melancholia” [2] He classified this as a new subtype of lypemanie, whose original features Cotard described as (a) melancholic anxiety, (b) condemnation or possession ideas, (c) suicidal behavior and voluntary mutilation, (d) insensitivity to pain, (e) nonexistence ideas involving the whole body or any of its parts, and (f) delusions of immortality, being these the original clinical features Cotard described [3, 4].
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