Cotard syndrome is defined as a mental disorder, in which the person thinks that she is dead, without being. That is to say, it ensures its existence as an undeniable fact. Mainly, it is a type of delirium, which is also known as nihilistic delirium or denial. It is rare, but some cases have been documented over the years.
Those who suffer from Cotard syndrome, deny that their body exists, that they have nerves, brain, blood and internal organs, as well as the other parts of it. They think that they live in an improbable and fictitious way. They even think that they suffer the putrefaction of organs, being able to hallucinate with the smell of decomposition.
Some facts about Cotard syndrome
Characteristics of the syndrome
The individual usually suffers from an alteration in the intensity of their emotions, loses vital energy and is dominated by negativity. This may give way to Cotard syndrome.
Also, there is hyperactivity in the amygdala, damage in temporal-parental zones, inhibition in the left prefrontal part of the brain, among other aspects. Likewise, dopamine is reduced in its receptors.
The name of the syndrome is given thanks to the French neurologist Jules Cotard, who was the one who discovered it. The discovery was made after several patients with psychiatric disorders showed the delusions that characterize it.
The first patient that J. Cotard attended was a 43-year-old woman. This assured to have “neither brain, nor nerves, nor chest, nor entrails, only skin, and bones”. The patient, presented at a conference in the city of Paris in 1880 under the pseudonym Mademoiselle X, denied the existence of God and the devil, as well as the need to nourish themselves. She also believed that she was eternally condemned since she could not die a natural death.
It should be noted that the case presented by Dr. Cotard was not exempt from criticism and skepticism by the scientific community of the time.
Characteristic (pathological) symptoms
- Suicidal thoughts.
- Belief that your body does not exist
- The belief that they are running out of blood.
- Negative thoughts.
- The belief that they are already dead – with olfactory delusions, they even smell that they are rotting.
- The belief that the worms are under your skin.
- The belief that they are immortal.
- The belief that they are decomposing.
- The belief that they do not have internal organs.
- Analgesia or absence of pain.
Remember, before being evidenced and documented by Dr. Cotard, these symptoms were associated with suppositions and disorders of human behavior associated with the culture, religion, ethnicity, and any other element distancing the established as the moral and healthy standard of the epoch Eye! This is an important fact.
Description of the pathology in patients
Although it is a typical delirium of the most severe depressions (psychotic or delirious) can be seen in other severe mental illnesses (dementia with psychotic symptoms, schizophrenia, psychosis due to medical or toxic diseases).
However, it is important to note that patients come to believe that their internal organs have paralyzed all function, that their intestines do not work, that their heart does not beat, that they do not have nerves, blood or brain and even that they are rotting. As a result, they come to present some olfactory hallucinations that confirm their delirium (unpleasant smells, like rotting flesh), they can even say that they have worms sliding on their skin.
Some treatments that are carried out
This type of diseases is not easy to treat, and less when the diagnosis involves elements of other diseases already classified and less controversial, but here are a series of steps that doctors apply depending on the complexity and situation per individual:
Pharmacological combination (pills, injections, sedatives, etc.).
Antidepressant drugs such as mirtazapine, antipsychotics, or olanzapine.
If the drugs are not effective, it can be treated with electroconvulsive therapies.
Etiology or classification of the disease
Cotard syndrome is a disease of character, treatment, and neurological-mental specialty. What makes it a tremendous chasm for professionals in this medical discipline, due to its few diagnosed cases and the controversy between dementia and a delirium-disorder.