Cotard delusion
| Cotard delusion | |
|---|---|
| Synonyms | Cotard's syndrome, walking corpse syndrome |
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| The neurologist Jules Cotard (1840–89) described "The Delirium of Negation" as a mental illness of varied severity. | |
| Classification and external resources | |
| Specialty | Psychiatry |
| ICD-10 | F22 |
| ICD-9-CM | 297.1 |
Cotard delusion is a rare mental illness in which the affected person holds the delusional belief that they are already dead, do not exist, are putrefying, or have lost their blood or internal organs. Statistical analysis of a hundred-patient cohort indicates that the denial of self-existence is a symptom present in 69% of the cases of Cotard's syndrome; yet, paradoxically, 55% of the patients present delusions of immortality.
In 1880, the neurologist Jules Cotard described the condition as Le délire des négations ("The Delirium of Negation"), a psychiatric syndrome of varied severity. A mild case is characterized by despair and self-loathing, while a severe case is characterized by intense delusions of negation and chronic psychiatric depression. The case of Mademoiselle X describes a woman who denied the existence of parts of her body and of 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 "The Delirium of Negation", Mademoiselle X died of starvation.
The Cotard delusion is not mentioned in either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization.
The delusion of negation is the central symptom in Cotard's syndrome. The patient afflicted with this mental illness usually denies their existence, the existence of a certain body part, or the existence of a portion of their body. Cotard's syndrome exists in three stages: (i) Germination stage—the symptoms of psychotic depression and of hypochondria appear; (ii) Blooming stage—the full development of the syndrome and the delusions of negation; and (iii) Chronic stage—continued, severe delusions along with chronic psychiatric depression.
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