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Psychiatric features of vCJD similar in France and UK

Department of Psychiatry, BP 27, Centre Hospitalier Général, F-91401 Orsay, France

We report a case of new variant Creutzfeld-Jakob disease (vCJD) in a French 36-year-old woman. The patient was initially admitted to our psychiatric department in the suburbs of Paris. She presented with psychiatric symptoms for 6 months: major depressive disorder and personality change including apathy, emotional lability and infantile affect. There were no specific psychiatric features allowing distinction from common depressive disorders. Drug treatments, clomipramine (125 mg/day) and venlafaxine (200 mg/day), were used with no benefit. She subsequently presented with delusions and auditory hallucinations that occurred transiently over a period of some hours. The delusions coincided with the onset of cognitive impairment: disorientation and memory impairment. Electroencephalogram showed non-specific slow-wave activity.

Neurological symptoms developed 7 months after the onset of depressive symptoms and included cognitive impairment, ataxia, myoclonus, excessive daytime drowsiness and headache. The patient tested negatively for the P14.3.3 protein in cerebrospinal fluid. She had no history of potential iatrogenic exposure. She was referred to a neurology department. Imaging investigations and neuropathological confirmation by cerebral biopsy have been detailed elsewhere (Oppenheim et al, 2000). The patient died in a state of akinetic mutism.

The psychiatric features of this French case of vCJD are clinically consistent with the cases identified in the UK (Zeidler et al, 1997; Allroggen et al, 2000; Will et al, 2000). The patient fulfilled diagnostic criteria for vCJD used by the National CJD Surveillance Unit (Will et al, 2000). The relationship between vCJD and bovine spongiform encephalopathy highlights the need for clinical surveillance in France as in the UK.

REFERENCES

Allroggen, H., Dennis, G., Abbott, R. J., et al (2000) New variant Creutzfeldt — Jakob disease: three case reports from Leicestershire. Journal of Neurology, Neurosurgery and Psychiatry, 68, 375 -378.[Abstract/Free Full Text]

Oppenheim, C., Brandel, J.-P., Hauw, J.-J., et al (2000) MRI and the second French case of vCJD (letter). Lancet, 356, 253 -254.[CrossRef][Medline]

Will, R. G., Zeidler, M., Stewart, G. E., et al (2000) Diagnosis of new variant Creutzfeldt—Jakob disease. Annals of Neurology, 47, 575 -582.[CrossRef][Medline]

Zeidler, M., Johnstone, E. C., Bamber, R. W., et al (1997) New variant Creutzfeldt—Jakob disease: psychiatric features. Lancet, 350, 908 -910.[CrossRef][Medline]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dervaux, A. Articles by Borgne, M.-H. L. Search for Related Content PubMed Articles by Dervaux, A. Articles by Borgne, M.-H. L.