title: Cotard's syndrome in adolescents and young adults is associated with an increased risk of bipolar disorder.
abstract: OBJECTIVE
  To assess the effect of age at onset on the phenomenology of Cotard's syndrome (CS) as a recent study reported a high rate of occurrence of bipolar disorder (BD) in adolescents and young adults with CS followed up for > or =2 years.
  
  
  METHODS
  We reviewed all cases of CS reported since it was first described. A statistical analysis was carried out to determine the effect of age at onset on CS phenomenology.
  
  
  RESULTS
  We found 138 cases including 21 cases aged 25 years or younger. In these younger CS patients, BD was more frequent, and the risk of associated BD was increased nine times (p < 0.0001). Within the BD sub-group (n = 27), admixture analysis identified two sub-groups with mean ages at onset of 18.7 years [standard deviation (SD) = 3.2] and 50.5 years (SD = 11.7).
  
  
  CONCLUSIONS
  Young people with CS should be monitored carefully for the onset of BD, and families should be educated about this risk. Treatment with mood stabilizers can be helpful for those who develop BD. Within BD associated with CS, early versus late onset should be distinguished.
authors.affiliation: Department of Child and Adolescent Psychiatry, Comportement et Cognition, Université Pierre et Marie Curie, Assistance Publique, Hopitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France.
authors.forename: Angèle
authors.initials: A
authors.lastname: Consoli
authors.forename: Charlotte
authors.initials: C
authors.lastname: Soultanian
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Tanguy
authors.forename: Claudine
authors.initials: C
authors.lastname: Laurent
authors.forename: Didier
authors.initials: D
authors.lastname: Perisse
authors.forename: Rogelio
authors.initials: R
authors.lastname: Luque
authors.forename: German E
authors.initials: GE
authors.lastname: Berrios
authors.forename: David
authors.initials: D
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D017668:Age of Onset; D001714:Bipolar Disorder / Q000209:etiology / Q000503:physiopathology*; D003702:Delusions; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000503:physiopathology; D012306:Risk; D013577:Syndrome