When the Patient Believes That the Organs Are Destroyed: Manifestation of Cotard's Syndrome.

Leonardo Machado,Liliane Machado,Luiz Evandro De Lima Filho

doi:10.1155/2016/5101357

Leonardo Machado, Liliane Machado + Show 1 more

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https://doi.org/10.1155/2016/5101357

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Abstract

Cotard's Syndrome (CS) is a rare clinical event described for the first time in 1880 by the neurologist and psychiatrist Jules Cotard and characterized by negation delusions (or nihilists). Immortality and hypochondriac delusions are also typical. Nowadays, it is known that CS can be associated with many neuropsychiatric conditions. In this article, we describe the case of a patient that believed not having more organs and having the body deformed and whose CS was associated with a bigger depressive disorder. Although the electroconvulsive therapy is the most described treatment modality in the literature, the reported case had therapeutic success with association of imipramine and risperidone.

Highlights

Cotard’s Syndrome (CS) is a rare clinical event, characterized by negation delusion, generally regarding the body or regarding the existence, and concerning concepts/conditions [1]
Other typical delusions are immortality delusion [3] and hypochondriac delusions [1, 4]. This condition was described with details in 1880 by the Parisian neurologist and psychiatrist Jules Cotard [5]
Cotard formulated that the condition would be a new kind of depression characterized by anxious melancholy, condemnation of ideas, insensitivity to pain, negation delusion of the organs, and immortality delusion

Summary

Introduction

Cotard’s Syndrome (CS) is a rare clinical event, characterized by negation delusion (or nihilist), generally regarding the body (frequently the patient believes that he or she does not have one or more organs) or regarding the existence (the individual judges that himself or everybody in the world is dead or reduced to nothing, being able to judge himself a zombie), and concerning concepts/conditions [1] (such as a CS case described in which a woman was sure about not being pregnant, despite of obvious evidences [2]). Other typical delusions are immortality delusion (the individual believes that nothing more can kill him, in this case because he is already dead) [3] and hypochondriac delusions (in which the patient judges to be suffering of a very serious or incurable disease or having the body deformed) [1, 4]. This condition was described with details in 1880 by the Parisian neurologist and psychiatrist Jules Cotard [5]. It is necessary that the clinicians be aware to the many possibilities of manifestation of this syndrome and, because of that, we describe in this article a CS case with negation delusions of organs and hypochondriac

Case Presentation

Discussion

Conclusion