Abstract

Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient's symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.

Highlights

  • Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions

  • We report on a patient with known schizophrenia and history of opioid abuse that developed a Cotard syndrome (CS) one year after medication dropout

  • We present an uncommon form of CS as the patient did not display any depressive symptoms associated with his nihilistic delusions

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Summary

Introduction

Cotard syndrome (CS) has been described by Jules Cotard (1880) as a nihilistic delusion, which may range from negation of existence of parts of the body to delusion of being dead and negation of self-existence. This syndrome can be found in numerous psychiatric or neurologic conditions, such as mood disorders, schizophrenia and other psychotic disorders, dissociative disorders, central nervous system (CNS) infections, cerebrovascular disease, CNS neoplasm, and traumatic brain injury [1,2,3]. CS typically affects middleaged or older people and the typical picture includes depressive mood, which is present in approximately 90% of cases described in the literature [1]. Only few cases have been described reporting CS without depressive symptoms

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