Cotard's syndrome in adolescents and young adults is associated with an increased risk of bipolar disorder.
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.
Consoli
Angèle
A
Department of Child and Adolescent Psychiatry, Comportement et Cognition, Université Pierre et Marie Curie, Assistance Publique, Hopitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France.
Soultanian
Charlotte
C
Tanguy
Marie-Laure
ML
Laurent
Claudine
C
Perisse
Didier
D
Luque
Rogelio
R
Berrios
German E
GE
Cohen
David
D
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