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IntroductionIn 1880 Cotard introduced the term, “délire de negation”, which referred to nihilistic delusions and has come to be known as Cotard’s syndrome. This condition is thought to be characterized by various degrees of delusional beliefs in which different aspects of existence are negated or experienced from a negative perspective.ObjectivesThe historical concept of Cotard’s syndrome, its clinical presentation and treatment is briefly reviewed.AimsTo report a case study of Cotard’s syndrome associated with self-starvation and to review the concept and clinical features of the condition.MethodsA detailed clinical history was obtained from several interviews and a literature review of the theme is shortly surveyed.ResultsA woman of 66 years, without any psychiatric history prior 2012, developed a clinical picture of depressed mood and sudden onset of delusions of ruin, ill health, guilt and self-starvation. She believed that her esophagus and stomach were glued together, so that it was not possible for her to ingest any food. She also refused to go outside because she believed she was malodorous (she had olfactory hallucinations). The patient started experiencing these symptoms after her husband’s unexpected death, a few months prior to admission. She was treated with high doses of antidepressants and an antipsychotic.ConclusionsCotard’s syndrome in this case study is associated with depression. Attempting to understand individuals with the condition from both a phenomenological as well as biological viewpoint may eventually pave the way for clearer connections between psychological and biological causation of the syndrome.

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Introduction:The French nosological concept of bouffée délirante (literally “delusional flush or rush”) may define a subgroup of non-affective, acute remitting psychoses with an especially favourable prognosis. To date, relatively little published literature is available about this entity.Objectives:To discuss the concept, nosological status, diagnostic features and associated clinical characteristics of bouffée délirante.Aims:A case report of bouffée délirante is described. The concept and clinical features of the condition are reviewed.Methods:A case report is presented in detail and a literature review of the theme is surveyed.Results:The authors report a case of a 48-year-old woman with no psychiatric background until November 2011 when she developed a sudden onset of persecutory delusions concerning her colleagues and boss. She believed computers and televisions were under their control and that her daughter and husband were in danger. This information was given by the voices she believed to hear. During one week, she developed behavior disturbance that motivated her urgent evaluation. As she was admitted to our department, she showed herself defensive and hostile. During the first day in our ward she described a delusion of Capgras, but the symptoms were rapidly overtook with low doses of antipsychotic.Conclusions:Bouffée délirante is a historic French diagnostic term used in the past to describe a short-lived psychosis. The term was substituted differently in ICD-10 (described as acute and transient psychotic disorders) and DSM-IV-TR (brief psychotic disorder). The key diagnostic features are acute, floridly psychotic symptoms with complete remission.

IntroductionAlthough schizophrenia is generally regarded as an illness with onset in late adolescence or early adult life, a sizeable minority of patients first become ill in middle or old age. Inconsistencies in diagnostic systems and nomenclature have led to such cases occupying an ambiguous position in relation to schizophrenia.ObjectivesTo present a case study describing a late-onset schizophrenia and to clarify the position of this diagnose in the current nosology.AimsThe concept, nosological status, diagnostic and associated clinical features involved in late-onset schizophrenia are reviewed.MethodsA case report is presented in detail and a literature review of the theme is surveyed.ResultsWe report a case of a 66-year-old woman with no psychiatric background up until 2010 when she was compulsively admitted to our department due to a clinical picture, which she has been developing since 2008, of mystical and persecutory delusions and visual and auditory hallucinations (she believed she was persecuted by little witches whom insulted her and invaded her home). This led to a behavioral disturbance with intense aggressiveness and anguish. The neuropsychological evaluation didn’t detect any cognitive impairment. She was treated with high doses of an antipsychotic and discharged being medicated with injectable antipsychotic and followed in compulsory treatment.ConclusionsIn terms of epidemiology, symptom profile, and identified pathophysiology, the diagnose of late-onset schizophrenia (illness onset after 40 years of age) has face validity and clinical utility. General adoption of this category will foster systematic investigation of such patients.