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The cotard syndrom, when graveyard is where they belong

cotard "Canadian Corps - Canadian war graves" by Unknown - This image is available from Library and Archives Canada under the reproduction reference number PA-000176 and under the MIKAN ID number 3403327This tag does not indicate the copyright status of the attached work. A normal copyright tag is still required. See Commons:Licensing for more information.Library and Archives Canada does not allow free use of its copyrighted works. See Category:Images from Library and Archives Canada.. Licensed under Public Domain via Commons.

‘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

 

cotard

Jules Cotard” by Jules Cotard(Life time: 1889) – Original publication: N.AImmediate source: http://thechirurgeonsapprentice.com/2012/10/31/real-life-zombies-a-history-of-cotards-delusion/. Licensed under PD-US via Wikipedia.

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

-Chronic stage

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 :

-Haley Smith

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.

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