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 (Reference Oppenheim, Brandel and HauwOppenheim 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 (Reference Will, Zeidler and StewartZeidler et al, 1997; Reference Allroggen, Dennis and AbbottAllroggen et al, 2000; Reference Will, Zeidler and StewartWill et al, 2000). The patient fulfilled diagnostic criteria for vCJD used by the National CJD Surveillance Unit (Reference Will, Zeidler and StewartWill et al, 2000). The relationship between vCJD and bovine spongiform encephalopathy highlights the need for clinical surveillance in France as in the UK.