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Cotard's syndrome with schizophreniform disorder can be successfully treated with electroconvulsive therapy: case
Okan Caliyurt1, Erdal Vardar, Cengiz Tuglu
1Psychiatry Department, School of Medicine, Trakya University, Edirne, Turkey. caliyurt@hotmail.com
Journal of Psychiatry & Neuroscience : JPN
|April 8, 2004
Summary
This case study highlights Cotard's syndrome, a rare mental disorder, presenting with psychotic symptoms and somatic delusions. Electroconvulsive therapy proved effective when antipsychotics failed, suggesting it as a potential first-line treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Neurology
Background:
- Cotard's syndrome is a rare neuropsychiatric disorder characterized by delusions of negation.
- Psychotic symptoms, including somatic delusions, can co-occur with Cotard's syndrome.
- Schizophreniform disorder is a diagnostic consideration for patients presenting with acute psychotic symptoms.
Observation:
- A 27-year-old male diagnosed with schizophreniform disorder exhibited symptoms of Cotard's syndrome.
- The patient experienced somatic delusions of gastrointestinal and cardiovascular malfunction, including the absence of a stomach, leading to significant weight loss.
- Neuroimaging revealed left hemisphere abnormalities, including lateral and third ventricle dilatation, central atrophy, and hypoperfusion in the left temporal, frontal, and parietal regions.
Findings:
- The patient's psychotic symptoms did not improve with antipsychotic medications.
- Successful treatment was achieved with electroconvulsive therapy (ECT).
- The findings suggest a potential association between Cotard's syndrome, left hemisphere lesions, and psychotic symptoms.
Implications:
- Electroconvulsive therapy may be a viable first-line treatment for Cotard's syndrome with psychotic features.
- Neuroimaging findings underscore the importance of evaluating for neurological abnormalities in Cotard's syndrome.
- This case contributes to understanding the complex interplay between neurological deficits and psychiatric manifestations in Cotard's syndrome.