After explaining Cotard's syndrome and its different developments from 1880 to 1992 by recelling the relations of nihilistic delusions with melancholia and pointing out the topicality of the research (more particularly in the last ten years), we'll give an account of four clinical cases: two cases involving two women aged 69 and 82, undergoing a plain melancholic episode; a case of post-melancholia paraphrenia, and a case of systemized nihilistic delusions during a post-partum melancholia. In the four cases, recovery was achieved thanks to electroconvulsive therapy. The third stage of this work considers the phenomenological and descriptive, as well as physiological and psychoanalytical assumptions adopted by the authors. Lastly, a psychopathological explanation is suggested both from a nosographical point of view, in which nihilism is both a mechanism and a delirious theme, and from a "modelization" point of view distinguishing two stages in Cotard's syndrome: nihilism, and delirious reconstruction strictly speaking. Here will use the concept of negative hallucination which we think underlies this delirium, and from this idea, we'll eventually try to demonstrate how relevant the Freudian theory is in this field.

Adult↗

PubMedDate not supplied

[Comorbidity in a sample of hospitalized depressed patients].

In a retrospective study of 133 in-patients with a major depressive disorder, we first described the associated psychiatric (axis I and axis II) or somatic diseases (axis III). Then, we described the patients and therapeutical practices related to comorbidity. The results of this study showed that comorbidity concerned 89% of the patients. The mean number of diagnosis was 2.5 per patient (sd = 0.88). 33% of subjects had an associated diagnosis on axis I; 57% of subjects had an associated diagnosis on axis II; 47% of subjects had an associated diagnosis on axis III. Number of drugs prescribed was positively correlated to age (p < 0.05) and hospitalization duration (p < 0.01). Comorbidity was significantly more frequent in men than in women (p < 0.05). There was a positive correlation between comorbidity and the number of psychotropic drugs prescribed (p < 0.05). Compared to other subjects, subjects with an associated personality disorder were younger (p < 0.01), received more psychotropic drugs (p < 0.05) and less somatotropic drugs (p < 0.02). Compared to other subjects, subjects with an associated somatic disorder were older (p < 0.01), received more drugs (p < 0.01), in particular somatic drugs (p < 0.001). Compared to other subjects, subjects with an associated suicide attempt were younger (p < 0.001). However, these results should be considered with care because the numerous methodological limitations of this study, in particular the lack of standardized interviews and the lack of power.

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PubMedDate not supplied

[Psychotropic effects of acebutolol in hebephrenics. Preliminary study].

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Acebutolol↗