‘I’d fantasies about having picnics in graveyards and I’d spend a lot of time watching horror films because seeing the zombies made me feel relaxed, like I was with family.”
The man explained that he was dead, and was concerned that no one had buried him yet!
“Have you considered Cotard syndrome? It’s a rare delusional disorder in which a person believes that he or she is dead… Even those closest to them seem like impostors”
Hannibal, Season 1 – episode 10
The walking corpse syndrome or Cotard syndrome
is a very rare mental illness in which patients believe they are dead, or part of their body is dead
Patients might believe they are putrefying, they have a rotten flesh and they are in their way to decay
The syndrome was first described by the French neurologist Jules Cotard who spent 15 years of his life studying delusions.
Cotard first described the syndrome as “Le délire des négations “ – “The Delirium of Negation”
Strangely enough, %55 of cases identify themselves with immortality !
The syndrome is characterized by going into 3 major stages:
-The Germination stage
Which’s characterized by psychotic depression –major episode of depression with 2 or more psychotic signs as hallucinations and delusions –
And hypochondria – patients believe they are physically ill without any apparent symptoms –
-The blooming stage
Full development of the syndrome with distorted reality sensation
Delusions with psychotic depression
Where’s the problem?
The exact etiology of Cotard syndrome is unknown
It might be associated with Capgras delusion
The 2 primary centers of brain that believed to be part of the problem are the Fusiform face area – part of visual system responsible for facial recognition –
And the Amygdala – almond shaped nuclei responsible for emotional reaction and memory –
They theory assumes a misfiring in those 2 areas and neuronal disconnection leading lack of facial recognition with distorted emotional reaction where patients believe their friend and family had been replaced by impostors with the same faces! – Capgras delusion –
And if patient saw his own face in a mirror, he/she won’t be able to identify it
Cotard is more common in people with psychosis, chronic depression, neurological illness and derealization
Also it’s estimated it’s more prevalent in patients with brain atrophy especially in frontal lobe
Famous Cases :
a 17 years old girl suffered from Cotard’s syndrome for 3 years
She reported first feeling ‘dead’ when she was in school, the sensation repeated days later when she was shopping
With time she believed she’s dead
“She said: ‘I’d fantasies about having picnics in graveyards and I’d spend a lot of time watching horror films because seeing the zombies made me feel relaxed, like I was with family.”
After extended psychotherapy she was cured
A surprising factor helped in her recovery was Disney movies!
She said: ‘‘Watching Disney films gave me a warm, fuzzy feeling.
I asked my boyfriend Jeremy: “How can I be dead when Disney makes me feel this good?”.’
– In 2009, Belgian psychiatrists reported the case of an 88-year-old man who came to their hospital with symptoms of depression. The man explained that he was dead, and was concerned that no one had buried him yet!. His delusions subsided with treatment.
–Greek psychiatrists received a patient in 2003 who believed he was literally empty-headed – without a brain- . He had attempted suicide years earlier because he thought it wasn’t worth living since he didn’t have a brain. He was not treated after the incident and simply returned to work. He was re-admitted the next year. This time he completed treatment and showed sustained improvement in a follow-up interview months later.