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.