title: A patient with Cotard syndrome who showed an improvement in single photon emission computed tomography findings after successful treatment with antidepressants.
abstract: We report the case of a presenile woman with Cotard syndrome, in the context of major depression, who showed an improvement in bilateral frontal hypoperfusion in a SPECT study using 99mTc-HMPAO after undergoing successful treatment with antidepressant therapy. We also retrospectively evaluated her clinical course based on the clinical stages. The symptoms of Cotard syndrome have been reported to change dramatically according to the stages. This peculiarity made it difficult for us to rapidly diagnose Cotard syndrome in the context of major depression, and not dementia, and thereby adequately treat the patient in our case. Differences in the reduced blood flow regions and a time lag from psychiatric remission were observed before the improvement in the SPECT findings when comparing our case with a previously reported case of Cotard syndrome. These differences suggest that the mechanism of Cotard syndrome is still not well understood at the present time.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. hashioka@f2.dion.ne.jp
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Hashioka
authors.forename: Akira
authors.initials: A
authors.lastname: Monji
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sasaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshida
authors.forename: Kanji
authors.initials: K
authors.lastname: Baba
authors.forename: Nobutada
authors.initials: N
authors.lastname: Tashiro
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D000928:Antidepressive Agents