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Diurnal variation in Cotard's syndrome (copresent with Capgras delusion) following traumatic brain injury
1Royal Rehabilitation Centre, Ryde, New South Wales, Australia. butlerp@doh.health.nsw.gov.au
Objective:
The aim of this paper is to document regular nocturnal intensification of delusional nihilistic and persecutory ideas (Cotard delusion) linked with extreme depersonalisation and hypervivid dreaming.
Clinical Picture:
A 17-year-old man presented with Cotard and Capgras delusions after sustaining multiple cognitive impairments secondary to traumatic brain injury.
Treatment And Outcome:
Delusional ideation fully resolved within 14 days of commencement of olanzapine 5 mg daily.
Conclusion:
This patient's experience of perceptual abnormalities and impairments in meta-abilities related to self-monitoring and critical inferencing lends support to multicomponent sensory processing accounts of brain injury related, content-specific delusional syndromes.