[Cotard's delusion of negations]

Area of Science:

• Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Major depressive disorder (MDD) is a common mental health condition.
• Cotard's delusion, a rare neuropsychiatric symptom, involves nihilistic beliefs such as delusions of being dead or internal organs not functioning.
• The co-occurrence of MDD and Cotard's delusion presents unique treatment challenges.

Observation:

• A sixty-two-year-old female patient presented with a year-long history of major depressive episode.
• The patient exhibited Cotard's nihilistic delusion, a severe symptom of her depression.
• Hospitalization was required due to the severity of her condition.

Findings:

• The patient received a combination treatment of clomipramine and olanzapine.
• This pharmacotherapy led to a rapid and significant improvement in her depressive symptoms.
• Humor and delusional thinking were successfully normalized following treatment.

Implications:

• This case highlights the efficacy of combined clomipramine and olanzapine in treating severe depression with Cotard's delusion.
• Early and aggressive pharmacotherapy may be crucial for managing complex depressive episodes.
• Further research into optimal treatment strategies for delusional depression is warranted.