Study

Study design

Sample Size

Assessment Time

Outcome Measures/ Instruments

Signs & Symptoms

Results

Limitations

Country

Kobayashi et al., 2012 [2]

Longitudinal Case study

n = 1

- 74 year old woman with cotard’s syndrome, depression, and Frontotemporal (FTD) dementia

- Previous 2 years of pharmacotherapy

1 - 2 years

Observed, cognitive assessments,

HDS-R scale (Dementia scale),

MMSE (mini mental state examination),

Brain CT scan

Brain MRI scan

Three-dimensional stereotactic surface projections (SPECT),

ECT (treatment)

Atypical and nihilistic behavior

Motor rigidity

limited word/verbal expression

Loss of appetite/anorexia

Claimed that she did not have her intestines, stomach, lungs, and even claimed that she is dead

The patient was given around a total of 18 ECT sessions which resulted in fluctuated mental condition, and overall her delusions, sluggishness, slowness, appetite, and psychotic symptoms (she did not claim any missing organs) improved. But then they deteriorated again, but the patient’s overall physical and mental state improved

Patient had FTD Dementia which is very specific, very confused about which symptoms were existing before or what symptoms were side effects of a disease (blurred lines between the symptoms of her diseases)

Relationship unclear

Small sample size (1), so the results of the study may be biased and cannot be generalized

Japan

Mughal, Menezes, 2013 [13]

Longitudinal study

n = 1

- 59 year old caucasian woman, history of depression with somatic symptoms, experienced loss of mobility, somatic symptoms resulting in suicidal ideals and complaints of pain without a definitive biological cause

About 2 months

ICD-10,

ECT,

Olanzapine,

Antidepressants

Antipsychotics

pipotiazine depot injection

Duloxetine

MRI

Verbal symptoms recorded/written

SOAD

Claims of persistent back and leg pain

Suicidal idealations

Psychosomatic symptoms, claiming physical/biological causes of symptoms

Somatisation

loss of mobility (psychosomatic)

Claimed she felt like a rotting corpse

Claimed legs rotting and falling off

After 4 weeks of persistent antipsychotic, antidepressant, and ECT combination therapy, patient felt much happier and attended to her personal hygiene, motor disability was repaired,

Nihilistic delusions resolved,

Better mood

No longer suicidal or homicidal

Case study, meaning the results cannot be generalized

The cotard’s syndrome was treated more as a symptom of the patient’s psychotic depression

United Kingdom