What Is Cotard Syndrome?

Often people who suffer from this syndrome also have suicidal behavior; thinking they are already dead, they consider themselves immortal and nothing seems to matter to them. 

Cotard syndrome is a mental disorder that causes a person to think they are dead: the person completely denies it exists.

This delirium is also known as “nihilistic delirium” or “delirium of negation”. This disorder is not common, but there are still a few cases.

People who suffer from this syndrome deny the existence of their body in general. More specifically, they often deny the existence of their nerves, brains, blood and internal organs.

They imagine that their life is fictitious, and think that their organs are decomposing, to the point of smelling a supposed smell of putrefaction emanating from their own body.

Characteristics of Cotard syndrome 

Usually the person experiences a change in the intensity of their emotions, their vital energy decreases and they are dominated by negative thoughts.

The person also suffers from hyperactivity in the amygdala. Some areas of the body are damaged. It is also possible to observe inhibition in the left prefrontal part of the brain, among others.

In addition, the presence of dopamine decreases in the latter’s own receptors.

Ethymology

This syndrome is named after the doctor who discovered it, the French neurologist Jules Cotard. The discovery was made by monitoring several patients with disorders psychiatric with delusions that characterize this syndrome.

The first patient with this syndrome followed by Jules Cotard was a 43-year-old woman.

The latter ensured that she had no brain, nerves, chest, or entrails, only skin and bones.

The patient was present at a conference in the city of Paris in 1880 under the pseudonym of Mademoiselle X. She also denied the existence of God and the devil, as well as the need for food.

She also believed that she was doomed eternally, because, according to her, she could not die a natural death.

It should be noted that the case presented by Dr. Cotard was the subject of many criticisms within the scientific community of the time, very skeptical of this syndrome.

Characteristic (pathological) symptoms

• Depression 
• Suicidal thoughts
• Belief that the body does not exist
• Conviction of losing more and more blood
• Negative thoughts
• Conviction of being already dead, conviction accompanied by an olfactory delirium (patients say they smell a putrefactive odor emanating from their body)
• Belief that under the skin are worms
• Feeling of immortality
• Conviction of being broken down
• Conviction of having no internal organs
• Analgesia or absence of pain
• Self-mutilation
  

Before bringing to light the existence of this disorder, these symptoms were associated with disturbances in human behavior related to culture, religion, ethnicity or some other element marking a distance from the moral and healthy norm of the era established by the company.

Warning ! This is important information.

Description of the pathology in patients with cotard syndrome

Although it is a delirium typical of the most severe depressions (psychotic or delusional), this type of delirium is also present in other severe mental illnesses such as dementia with psychothic symptoms, schizophrenia, psychoses .

Patients who suffer from Cotard syndrome consider that their internal organs have paralyzed all the functions of the body. Or that their bowels don’t work, their hearts don’t beat, they don’t have nerves, or blood, or brains. Their body is thus in the process of decomposing.

Therefore, they suffer from hallucinations which confirm their delirium. This is particularly the case with olfactory hallucinations (unpleasant smell of meat in the process of decomposing). They even have the impression of feeling worms moving under their skin.

Some treatments were  made

This type of disease is not easily treated, especially when the diagnosis mixes elements of other diseases already classified and less problematic.

In the case of Cotard syndrome, doctors follow certain procedures depending on the complexity and the patient’s situation:

• combination of drugs (pills, injections, sedatives, etc.)
• antidepressant drugs such as mirtazapine, antipsychotics, or olanzapine
• if the drugs are not effective, electroconvulsive therapy is given.

Etiology or classification of the cotard syndrome disease

Cotard syndrome is a neurological and mental illness.

Due to the low number of diagnosed cases and the controversy between dementia and delirium-disorder, this syndrome represents a huge chasm for professionals in this medical discipline.