Diurnal variation in Cotard's syndrome (copresent with Capgras delusion) following traumatic brain injury.

OBJECTIVE

The aim of this paper is to document regular nocturnal intensification of delusional nihilistic and persecutory ideas (Cotard delusion) linked with extreme depersonalisation and hypervivid dreaming.

CLINICAL PICTURE

A 17-year-old man presented with Cotard and Capgras delusions after sustaining multiple cognitive impairments secondary to traumatic brain injury.

TREATMENT AND OUTCOME

Delusional ideation fully resolved within 14 days of commencement of olanzapine 5 mg daily.

CONCLUSION

This patient's experience of perceptual abnormalities and impairments in meta-abilities related to self-monitoring and critical inferencing lends support to multicomponent sensory processing accounts of brain injury related, content-specific delusional syndromes.