Nihilistic delusions (Cotard Type I) in a patient with paranoid schizophrenia

Nihilistic delusions, also known as delires de negation, are specific psychopathological entities characterized by the delusional belief of being dead, decomposed or annihilated, having lost one's own internal organs or even not existing entirely as a human being. The world may be perceived as catastrophic, about to collapse or nonexistent at all. According to Jaspers (1959) "Nihilistic delusions in melancholia give us the prototype. The world does not exist anymore, the patient himself does not exist; he only appears to live and he must live like this forever. He has no feelings and he cares for nothing."(1) In the following report we present the clinical case of a schizophrenic patient with remarkable nihilistic delusions and ideations of immortality, successfully treated with haloperidol 15 mg, promazine 10 mg, valproate 1500 mg, diazepam 20 mg during an involuntary psychiatric treatment in our psychiatric ward.