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Query: UMLS:C0025362 (mental retardation)
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Laurence-Moon-Bardet-Biedl (LMBB) syndrome is a symptom complex that usually presents with retinitis pigmentosa, poly- or syndactyly, mental retardation, obesity and hypogenitalism. Cotard's syndrome is a state in which the central symptom is a delusion of negation. The case reported here is a combination of these two rare conditions.
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PMID:Laurence-Moon-Bardet-Biedl syndrome in combination with Cotard's syndrome. Case report. 864 59

The term "Cotard's syndrome" is used to describe a number of clinical features, mostly hypochondriac and nihilistic delusions, the most characteristic of which are the ideas "I am dead" and "my internal organs do not exist". Besides, anxious and depressed mood, delusions of damnation, possession and immortality, suicidal and self-mutilating behavior are included. The first description of the syndrome was made in 1880 by Cotard, who presented the case of a female patient in a lecture. He originally named it "hypochondriac delusion", and some years later "delusion of negations", while it was named "Cotard delusion" after his death. In international literature, the terms "nihilistic delusion" and "Cotard's syndrome" prevailed over "delusion of negations" and "Cotard delusion". In the present study we report the case of a 59 year-old woman, who was admitted to our department after a suicide attempt, and who showed symptoms of Cotard's syndrome for about two years, namely depressed mood, hypochondriac and nihilistic delusions, delusions of immortality and damnation, suicidal ideation, severe psychomotor retardation, diminished motivation and tendency to stay in bed. She never took the medication she was prescribed, and at times she refused to eat. During her hospitalization, there was performed a full blood panel and medical imaging, that showed chronic ischemic infarctions, periventricular leukoencephalopathy and diffuse cerebral atrophy in MRI. All the other test results were normal. She was administered treatment with haloperidol, mirtazapine and venlafaxine. Gradually, her psychomotor ability, motivation and mood improved, she didn't express suicidal ideation, her delusions were less intense and she was able to question them, but they weren't eliminated. She was discharged in improved condition, after 44 days. Cotard's syndrome isn't mentioned in the current classification systems (ICD-10, DSM-5). In literature though, it has been divided into three types, according to the clinical symptoms: psychotic depression, Cotard type I, and Cotard type II, and three stages have been proposed: germination stage, blooming stage and chronic stage. It has been associated with various medical conditions, such as cerebral infractions, frontotemporal atrophy, epilepsy, encephalitis, brain tumors, traumatic brain injury. Furthermore, it has been associated with psychiatric conditions, such as mental retardation, postpartum depression, depersonalization disorder, catatonia, Capgras syndrome, Fregoli syndrome, Odysseus syndrome, koro syndrome. Several reports about successful pharmacological treatments have been published, both monotherapies with antidepressants, antipsychotics or lithium, and by antidepressant and antipsychotic combination treatments. The most reported successful treatment strategy for Cotard's syndrome is electroconvulsive therapy (ECT), administration of which should follow current treatment guidelines of the underlying conditions.
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PMID:[Cotard's syndrome: Case report and a brief review of literature]. 2811 93

Cotard's syndrome is a neuropsychiatric disease characterized by a variety of nihilistic delusions, commonly associated with several psychotic and major affective disorders, and neurological diseases, including stroke, dementia, and mental retardation. A 39-year-old male with mental retardation developed Cotard's syndrome, following an important episode of fear. During admission to our neurological unit, the patient underwent an accurate assessment, including neuroradiological, clinical, and neuropsychological examinations. At the psychiatric evaluation, he presented nihilistic delusions, in which he negated the existence of his body parts and the existence of his family members. The neuropsychological assessment ruled out other possible causes of misidentification, including the post-traumatic stress disorder. Thus, since also organic causes of Cotard's syndrome were excluded, the correlation between fear and the syndrome has been postulated and the patient opportunely treated, using a multidisciplinary approach. Our case suggests that in predisposed individuals negative emotions, including fear, may lead to delusional syndromes.
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PMID:Cotard's Syndrome Triggered by Fear in a Patient with Intellectual Disability: Causal or Casual Link? 2943 80