Cotard’s Syndrome - a Case Study

Abstract

Cotard"s Syndrome (CS) is a relatively rare but highly impressive psychopathological condition. It is characterized by the presence of nihilistic delusions concerning the body and the non-existence of the self, with general feelings of unreality and the belief that one is dead or the world no longer exists, hypochondrial delusions, ideas of guilt and immortality.

First reported in 1880 by Jules Cotard, a French psychiatrist who described a "delire de negation", this clinical state was then believed to be a new type of agitated melancholia. Since then, similar cases have been reported worldwide and many authors have written about its possible etiology, some seeing CS as a syndrome, others as an independent entity, many including it in the psychotic disorders, but with the majority still defending it belongs to the affective spectrum.

It has been found that advanced age increases the likelihood of developing CS, being mostly found in middle-aged or old people. Although infrequently occurring in young people, some cases have been reported, 90% of these being females.

We present the case of a 31 year-old male who developed CS after one week at a traumatology ward, with a vertebral fracture and no neurologic commitment. He improved dramatically after a few days on antipsychotics and one antidepressant. We find this case relevant, not only because of the rarity of this syndrome in young males, but mainly to highlight the effectiveness of a prompt referral to the liaison psychiatry and its extreme importance at a general hospital.