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Cotard Syndrome (Walking Corpse Syndrome)
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Cotard syndrome, which occasionally goes by the name of walking corpse syndrome, is a disorder in which a person believes that they are dead or do not exist. When Jules Cotard described this disorder in 1882, he called it “le délire de négation”—the delusion of negation (Enoch & Ball, 2001). However, by the time the 1890s were over, the syndrome was more commonly referred to as Cotard syndrome. Of all of the disorders that one could have named after oneself, the disorder where the person believes themselves to be trapped between the worlds of the living and the dead is one of the more intriguing namesakes.
Cotard’s syndrome (le délire de négation)
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
Accessory symptoms of Cotard’s syndrome may include analgesia, mutism, self-mutilating urges, suicidal ideas, illusions and, in some cases, hallucinations. The latter may be visual but are much more commonly auditory. Their content always reflects a preoccupation with guilt, despair and death. Thus, one patient “sees the walls tremble” and believes the house to be mined. He fears the preparations for his execution, “the guillotine being erected.” Such experiences are more likely to be illusions based on strong effect rather than hallucinations. Others may have hallucinations of taste and smell, believing that they are rotting away, that their food is completely changed or that they are being offered filth, faecal matter or human flesh. Such patients have a tendency to self-mutilation and suicide.
MRCPsych Paper A1 Mock Examination 3: Answers
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
Explanation: Doppelganger refers to a delusion that a double of a person or place exists somewhere else. Cotard syndrome refers to a delusion of death, disintegration of organs and nonexistence. Delusions of doubles refer to a delusion that a person known to the person has been replaced by a double. Delusion of infestation refers to a delusion that one is infested by parasites. Delusion of pregnancy refers to a delusion that one is pregnant (usually the husband of a pregnant wife).
A hypothesis on Cotard’s syndrome as an evolution of obsessive-compulsive disorder
Published in International Review of Psychiatry, 2021
Michele Fabrazzo, Lisa Giannelli, Serena Riolo, Antonietta Fuschillo, Francesco Perris, Francesco Catapano
Differently from OCD, Cotard’s syndrome remains an unclassified clinical entity and an unexplainable medical issue. Such a matter prompts the clinicians to explore the neurocognitive mechanisms that regulate the sense of existence, the formation of beliefs, and the limits of personal knowledge and consciousness (Debruyne & Audenaert, 2012). Moreover, Cotard’s syndrome is not recognised as a disorder in nosological systems such as DSM-IV, DSM-5, and ICD-10 but it remains as a combination of symptoms associated with a medical condition. Accordingly, Cotard’s syndrome is considered secondary to various medical, neurological, and psychiatric disorders (Table 1) (Dieguez, 2018). The symptoms and evolution of the syndrome vary from ideas of the destruction of organs, body, and soul to the denial of one’s existence following which some patients may cease eating and start developing a tendency towards self-mutilation or suicidal behaviour.
The ‘dead man walking’ disorder: an update on Cotard’s syndrome
Published in International Review of Psychiatry, 2020
Carmine Tomasetti, Alessandro Valchera, Michele Fornaro, Federica Vellante, Laura Orsolini, Alessandro Carano, Antonio Ventriglio, Massimo Di Giannantonio, Domenico De Berardis
More than a century of clinical research on Cotard’s syndrome has deepened and clarified the knowledge of this unique nosological entity. In the time of the first studies, Cotard and other authors conceived the idea that the particular symptoms characterizing the syndrome might constitute a specific and well-defined psychiatric disorder. However, a considerable amount of reports in the successive decades more and more recognized CS symptoms as trans-topographical features that could arise in the context of different neuropsychiatric diseases, although preserving distinctive symptomatologic elements, which could persist even after the partial remission of the underlying pathology, or also proving treatment-resistance and worsening its prognosis. This widespread presence of CS symptoms in different pathologies has, in part, made difficult its systematic classification as a separate entity. At present, it is not recognized as a nosographic entity in either the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) – where it falls under the category of ‘somatic delusions’ – or the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organization.
Cotard and Capgras delusions in a patient with bipolar disorder: “I’ll prove, I’m dead!”
Published in Psychiatry and Clinical Psychopharmacology, 2018
Mehmet Hamdi Örüm, Aysun Kalenderoğlu
Treatment strategies for Cotard and Capgras delusions have not been widely discussed. The most commonly applied procedure, quite rightly, is symptomatic treatment. Antipsychotics, antidepressants, and mood stabilizers will be administered in the light of diagnosis of the underlying major mental disorder. General medical conditions should always be considered, treated if identified or excluded. Where there is risk of suicide, this must be addressed to make the patient safe and this may influence the choice of definitive treatment. Electroconvulsive therapy might be used to achieve rapid resolution of depressive mood when individuals have suicidal thoughts. There are some pharmacologic treatment possibilities for Cotard syndrome but the most reported treatment strategy for the Cotard syndrome as, an instance of severe psychotic depression, is ECT. Monotherapy with agents such as amitriptyline, olanzapine, or lithium has been reported to be effective. However, combination strategies are used such as risperidon/fluoxetine, clozapine/fluvoxamine/imipramine. Using lithium is beneficial in bipolar disorder type-1 comorbidity [13]. In treatment of Capgras symptoms, antipsychotics are usually helpful. In our case, although there was a suicide attempt, we managed the patient successfully with oral and intramuscular drugs. Psychotic symptoms were decreased by using clozapine and affective symptoms by using valproic acid [14]. Most probably, there was a resistance to the drugs prescribed previously.