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Cotard'S Syndrome: Don'T Trust The Living
Cotard'S Syndrome: Don'T Trust The Living
Mrs. X, a 43 year old woman affirms she had no brain, nerves, no chest, stomach or
intestines.
There’s only skin and bones of a decomposing body.
She denied the existence of part of her body and her need to eat.
She said that she was condemned to eternal damnation and therefore, could not die a
natural death.
In the course of suffering, she died of starvation.
WHAT CAUSES COTARD’S SYNDROME?
The medical condition is characterized The risk factors are depressive disorders,
by mental disorders and delusions. mental problems like schizophrenia,
Most often the syndrome appears in the bipolar disorders and dementia.
case of schizophrenia or affective Also Cotard’s syndrome is associated
psychosis and often associated with with brain atrophy, brain tumors, brain
temporal lesions of subdominant injuries, seizure disorders, strokes and in
hemisphere of the brain and migrane some cases Parkinson’s disease.
attacks.
Often Cotard’s delusion is the result of
organic brain syndrome.
SIGNS AND SYMPTOMS
The first stage of Cotard’s is the germination stage. Here, the patient suffers from
psychotic depression and hypochondria, neglect of personal hygiene and physical health.
The patient has no interest in social life.
This is followed by the blooming stage. Here the disorder is fully developed and there
are delusions of negation. This prevents the patient from perceiving external reality
which then produces a distorted view of the external world. It also leads to severe
hallucinations, suicidal tendencies, negativity or insensitivity to pain.
The final stage is called the chronic stage. It is characterized by continued severe
delusions, chronic psychiatric depression. Patients deny self existence or the existence of
one or more body parts. They believe they are putrefying (they can even smell rotting
flesh) or lost vital organs.
BIOLOGICAL BASIS
There’s no specific diagonistic criteria for the Cotard’s syndrome. According to the
DSM-5, (Diagnostic and Statistical Manual of Mental Disorder, 5th edition), Cotard
delusion falls under the category of Somatic delusions, those that involve bodily
functions or sensations.
There are no further diagnostic criteria for Cotard’s syndrome within the DSM-5, and
identification of the syndrome relies heavily on clinical interpretation.
Cotard delusion should not be conused with delusional disorders as defined by DSM-5,
which involve a different spectrum of symptoms that are less severe and have lesser
detrimental effect on functioning.
Cotard’s syndrome is mainly diagnosed in association with the mental illness that
triggered it like bipolar disorder, schizophrenia, etc.
TREATMENT
A complete recovery might occur as spontaneously and as suddenly as its onset, even in the most
severe cases. The prognosis can mostly be linked to the underlying disorder.
If the nihilistic delusions are related to an acute psycho-organic syndrome, the prognosis is good
and the condition tends to resolve. If however, it is associated with a depressive illness, it may
well persist even when the other symptoms of the depressive illness have cleared.
Under this circumstance, and where the conditions become chronic, the delusional state of
negations usually waxes and wanes in intensity depending on the fluctuation of the depressive
disorder.
When the phenomenology is part of a schizophrenic illness, it usually improves when the other
symptoms respond to therapy, but it can also persist for years as part of a chronic schizophrenic
condition.
CONCLUSION
Research shows Cotard’s syndrome is a serious, life threatening condition that should be
examined further so individuals know more about it and get proper treatment. There are
many forms of Cotard’s syndrome that affect patients in somewhat different but similar
ways.
It is unpredictable because not much is known about the causes of Cotard’s syndrome.
With further research the causes of Cotard’s syndrome may become clearer, more
treatment options may become available, and a more predictable, and hopefully positive,
prognosis may arise.