Abstract

Introduction“Cotard syndrome” is a rare condition characterized by a constellation of clinical features, including hypochondriac and nihilistic delusions, the most characteristic of which are the ideas that one is dead or that their organs do not exist. It is more commonly associated with psychotic depression and schizophrenia but can also be found in several neurological disorders. In the clinical practice it generally appears as an “incomplete Cotard”, reduced to hypochondriac delusions attributed to the malfunction or occlusion of the organs, usually the digestive tract and abdominal viscera. Consequently it is common for these patients to reject food or medications. In literature it has been divided into three types, according to the clinical symptoms: psychotic depression, Cotard type I, and Cotard type II.ObjectivesLiterature review on Cotard Syndrome and its link with Multiple Sclerosis, based on a clinical case.MethodsPubmed and Google Scholar search using the keywords Cotard Syndrome, Multiple Sclerosis.ResultsHereby we present a clinical case of a 53-year-old female patient, with multiple sclerosis, who presented with hypochondriac and nihilistic delusions and refusal of food and medication. The patient was treated with olanzapine with rapid remission of delusional activity.ConclusionsMultiple sclerosis is an immunemediated chronic disease, affecting predominantly the sensory and motor function. In addition, psychiatric comorbidity is very frequent with up to 50 % lifetime risk of depression. While various neurological disorders have been described in association with Cotard syndrome, its link with multiple sclerosis has been scarcely reported.DisclosureNo significant relationships.

Highlights

  • Shared psychotic disorder or Folie a deux is an unusual mental disorder characterized by the transfer of delusions between two or more people who have a close relationship

  • The objective of this study is to describe the clinical characteristics of an unusual entity such as shared psychotic disorder

  • Description of a clinical case of shared psychotic disorder of a family treated in the emergency room during confinement

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Summary

Introduction

Onset and course of schizophrenia suggest estrogens have a protective role. Results: Accumulating evidence has led to the hypothesis that estrogens act as a protective factor in women regarding the onset of schizophrenia as their increase in puberty may help delay the onset of symptoms. Clinical trials testing the efficacy of estrogens have been promising, which suggest they might be a useful adjuvant treatment. Despite the evidence of clinical efficacy, health risks for women using estrogen therapy should be considered, as they decrease its acceptability as a viable treatment option. Conclusions: In conclusion, estrogens are proving to be a promising option as a complementary therapy for schizophrenia; further studies are needed to investigate whether they might be overall beneficial.

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