A case study of Cotard's syndrome: stages and diagnosis

We report the case of a middle-aged woman with Cotard's syndrome in whom cl inical course was evaluated according to stages. Longitudinally this syndro me seems to have three stages, namely germination, blooming and chronic (de pressive type/paranoid type) stages. In this patient, the chronic stage, pr imarily characterized by delusions, was observed without raising suspicion of affective disorder. She did not respond to any pharmacotherapies, but im proved dramatically after ECT performed during the chronic stage. Although symptoms change according to the stage, most cases of Cotard's syndrome may belong to the affective spectrum and are probably best treated with ECT,as documented here. In evaluation of the mode of separation between emotion a nd cognition during follow-up it is important to consider stage and diagnos is.