Cotard’s Syndrome: Clinical Case Presentation and Literature Review
Alessandro Carano
Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “C. G. Mazzoni”, NHS, 63100 Ascoli Piceno, Italy and Department of Neurosciences and Imaging, University “G. D’Annunzio”, 66100 Chieti, Italy
Domenico De Berardis *
Department of Neurosciences and Imaging, University “G. D’Annunzio”, 66100 Chieti, Italy and Psychiatric Service of Diagnosis and Treatment, Department of Mental Health, “G. Mazzini” Hospital, NHS, ASL 4, 64100 Teramo, Italy
Marilde Cavuto
IASM, 67100 L’Aquila, Italy
Carla Ortolani
IASM, 67100 L’Aquila, Italy
Giampaolo Perna
Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San BenedettoMenni, Albese con Cassano, 22302 Como, Italy
Alessandro Valchera
Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, 63100 Ascoli Piceno, Italy
Monica Mazza
Department of Health Science, University of L'Aquila; 67100 L’Aquila, Italy
Michele Fornaro
Department of Formative Sciences, University of Catania, 95100 Catania, Italy
Felice Iasevoli
Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine “Federico II,” 80131 Naples, Italy
Giovanni Martinotti
Department of Neurosciences and Imaging, University “G. D’Annunzio”, 66100 Chieti, Italy
Massimo Di Giannantonio
Department of Neurosciences and Imaging, University “G. D’Annunzio”, 66100 Chieti, Italy
*Author to whom correspondence should be addressed.
Abstract
In 1880 French neurologist Jules Cotard described a condition characterized by delusion of negation (nihilistic delusion) in a melancholia context. Recently, there has been a resurgence of interest in Cotard’s syndrome. The most prominent symptoms of Cotard’s Syndrome are depressive mood, nihilistic delusions concerning one’s own body and one’s own existence, delusions of guilt, immortality and hypochondria. The aim of the present paper is to review literature evidences concerning Cotard’s syndrome and to describe a clinical case keeping in the background the recent trends on its psychopathological implications. In the clinical study, the following sequence of stages emerged: the dissociative side, expressed as a loss of body-mind cohesion; the ‘mixed’ mood disorder, with depressive-manic episodes, and a persecutory background, all coexisting in the anguish of the idea of a body falling apart, the anguish of a descent towards the abyss of melancholia and/or an ascent to unlimited euphoria, characteristic of an “uncommon alarm” for loss of Self cohesion.
Keywords: Cotard, nihilistic delusion, melancholia, negation, depression