title: [Chronic Koro-like Syndrome (KLS) in recurrent depressive disorder as a variant of Cotard's delusion in an italian male patient. A case report and historical review].
abstract: Cotard’s syndrome is a delusional syndrome, first described in the 1880ies by Cotard, characterized by a nihilistic delusions about the self and/or the world. In same other cases there is an intense nihilistic belief that the patient’s entire body or parts of it are disintegrated or dead. The syndrome is often associated with severe depression, but are also described neurological cases. Koro was described a little later from Asia and consisted in the belief that one’s own genitalia are shrinking or disappearing and death will ensue thereafter, but there are many cultural variants and the syndrome may present in an incomplete form. We report on a KLS sharing more features with annihilation delusions, such as Cotard’s syndrome. In KLS, the délire de négation may be limited to localized systems or organs. We believe that some complete and incomplete forms of Koro, when embedded in a depressive core, may represent a variant of Cotard’s delusion. In fact, our patient did not reach a complete denial of his entire body, but rather focused on sexual identity. We analysed the psychosexual issues of our case according to Kretschmer’s 1918 view of a “bipolar setting” between sthenic and asthenic characters of a patient suffering from sensitive delusions of (self-) reference. This view may allow us to relate the personological character to the genetic comprehensibility of the delusion.
authors.affiliation: Department of Mental Health ASL Roma E, Psychiatric Emergency Unit, S. Filippo Neri Hospital, Rome. pluc.band@libero.it
authors.forename: Pier Luca
authors.initials: PL
authors.lastname: Bandinelli
authors.forename: Manuela
authors.initials: M
authors.lastname: Trevisi
authors.forename: Giorgio Demetrio
authors.initials: GD
authors.lastname: Kotzalidis
authors.forename: Giovanni
authors.initials: G
authors.lastname: Manfredi
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ducci
mesh_terms: D002908:Chronic Disease; D003702:Delusions / Q000209:etiology; D003866:Depressive Disorder / Q000150:complications*; D006801:Humans; D007558:Italy; D016911:Koro / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence