Concept
Cotard's syndrome, also known as Cotard's delusion or walking corpse syndrome, is a rare mental disorder in which the affected person holds the delusional belief that they are dead, do not exist, are putrefying, or have lost their blood or internal organs. Statistical analysis of a hundred-patient cohort indicated that denial of self-existence is present in 45% of the cases of Cotard's syndrome; the other 55% of the patients presented with delusions of immortality. In 1880, the neurologist and psychiatrist 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 (somatoparaphrenia) and of her need to eat. She claimed that she was condemned to eternal damnation, and therefore could not die a natural death. In the course of experiencing "the delirium of negation", Mademoiselle X died of starvation. Cotard's syndrome is not mentioned in either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the 10th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization. Delusions of negation are the central symptom in Cotard's syndrome. The patient usually denies their own existence, the existence of a certain body part, or the existence of a portion of their body. Cotard's syndrome exists in three stages: Germination stage: symptoms of psychotic depression and of hypochondria appear; Blooming stage: full development of the syndrome and delusions of negation; and; Chronic stage: continued severe delusions along with chronic psychiatric depression. Cotard's syndrome withdraws the person with the condition from other people due to neglect of their personal hygiene and physical health.