Cotard's Delusion

Cotard's delusion, also known as walking corpse syndrome or Cotard's 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 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.

Cotard's 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.

One patient, called WI for privacy reasons, was diagnosed with Cotard's delusion after experiencing significant traumatic brain damage. Damage to the cerebral hemisphere, frontal lobe, and the ventricular system was apparent to WI's doctors after examining magnetic resonance imaging (MRI) and computed tomography (CT) scans. In January 1990, WI was discharged to outpatient care. Although his family had made arrangements for him to travel abroad, he continued to experience significant persistent visual difficulties, which provoked a referral for ophthalmological assessment. Formal visual testing then led to the discovery of further damage. For several months after the initial trauma, WI continued to experience difficulty recognizing familiar faces, places, and objects. He was also convinced that he was dead and experienced feelings of derealization.

Later in 1990, after being discharged from the hospital, WI was convinced that he had gone to Hell after dying of either AIDS or sepsis. When WI finally sought out neurological testing in May 1990, he was no longer fully convinced that he was dead, although he still suspected it. Further testing revealed that WI was able to distinguish between dead and alive individuals with the exception of himself. When WI was treated for depression, his delusions of his own death diminished in a month.

In November 2016, the Daily Mirror newspaper carried a report of Warren McKinlay of Braintree in Essex, who developed Cotard's delusion following a serious motorbike accident.

## In Vampirology

Usually it's a connection that has been made by listicle sites sometime around the month of October with absurd titles such as "*10 Real Monster Facts You Didn't Know*", though the idea that the delusion has had an influence on developed vampire folklore and characteristics is occasionally discussed in more reasonable places.

### Reference 1

**This is excerpted from a paper by Cydney J. Christner, though Open assess, it is standard here at the Shoebox to not post full modern papers without explicit permission.**

 A common delusion experienced by people with schizophrenia that could also be included in this vampire theme is the Cotard delusion in which an individual believes they are dead.3 So, when an individual goes through the ritual to become a vampire, they may actually believe they have died due to Cotard delusion. The symptoms of agitation and violence presented by meth addiction along with this monothematic delusion could lead the individual to commit crimes, specifically murder, because they believe they are a vampire.

### Reference 2

**This is the Abstract from a paper by Garry Young, it is standard here at the Shoebox to not post full modern papers without explicit permission.**

Discussion on the Cotard delusion often focuses on the patient’s delusional belief that he/she is dead. Of interest to this paper, however, is the little referred to claim made by some Cotard patients that they are immortal. How might one explain the juxta-position of death and immortality evident in patients sharing the same clinical diagnosis, and how might these delusional beliefs inform our understanding of patient phenomenology, particularly regarding experiences of existential change? This paper sets out to explain delusions of death and immortality in Cotard patients with reference to changes in their experience of being, owed in part to a conflict in recognition evident in other delusional disorders such as the Capgras and Frégoli delusions. This experiential change is positioned within an interactionist framework of bottom-up and top-down processing that is also compatible with explanationist and endorsement approaches to delusions.

#### Reference 3

**This is excerpted from a Commentary and was written to respond to Reference 2 by Peter Fifield and Matthew Broome, it is standard here at the Shoebox to not post full modern papers without explicit permission.**

Young’s paper (2012) offers an interesting and fruitful extension to recent work on Cotard’s syndrome, and in particular, a philosophical investigation of how and why beliefs around death and non-existence frequently co-occur with beliefs around immortality. In this brief response, we discuss a few issues from the paper. Namely, the issue of Cotard delusion being a natural kind, the seeming paradox of death and immortality and its relation to wider culture and literature, and the utility of the concept of misplaced being.

## References

1. ↑ Berrios G.E.; Luque R. (1995). "Cotard's delusion or syndrome?". Comprehensive Psychiatry. 36 (3): 218–223. doi:10.1016/0010-440x(95)90085-a. PMID 7648846.
2. ↑ Berrios G.E.; Luque R. (1995). "Cotard Syndrome: Clinical Analysis of 100 Cases". Acta Psychiatrica Scandinavica. 91 (3): 185–188. doi:10.1111/j.1600-0447.1995.tb09764.x. PMID 7625193.
3. ↑ http://www.whonamedit.com/synd.cfm/2552.html
4. ↑ Berrios G.E.; Luque R. (1999). "Cotard's 'On Hypochondriacal Delusions in a Severe form of Anxious Melancholia'". History of Psychiatry. 10 (38): 269–278. doi:10.1177/0957154x9901003806. PMID 11623880.
5. ↑ Debruyne H.; et al. (Jun 2009). "Cotard's syndrome: a review". Curr Psychiatry Rep. 11 (3): 197–202. doi:10.1007/s11920-009-0031-z. PMID 19470281.
6. ↑ Debruyne Hans; et al. (2011). "Cotard's Syndrome". Mind & Brain. 2.
7. ↑ Halligan, P. W., & Marshall, J. C. (2013). Method in madness: Case studies in cognitive neuropsychiatry. Psychology Press.
8. ↑ https://www.mirror.co.uk/news/real-life-stories/soldier-walking-corpse-after-rare-9367576
9. ↑ Christner, Cydney J. (2019) "Explaining the Vampire Legend through Disease," Undergraduate Research Journal: Vol. 23 , Article 5. Available at: https://openspaces.unk.edu/undergraduate-research-journal/vol23/iss1/5
10. ↑ Young, Garry. "Delusions of Death and Immortality: A Consequence of Misplaced Being in Cotard Patients." Philosophy, Psychiatry, & Psychology, vol. 19 no. 2, 2012, p. 127-140. Project MUSE muse.jhu.edu/article/484349.
11. ↑ TY - JOUR T1 - Intimations of Immortality A1 - Fifield, Peter A1 - Broome, Matthew JF - Philosophy, Psychiatry, & Psychology VL - 19 IS - 2 SP - 141 EP - 144 PY - 2012 PB - Johns Hopkins University Press SN - 1086-3303 UR - https://muse.jhu.edu/article/484350 N1 - Volume 19, Number 2, June 2012 ER

## Additional Reading

* Ruminjo A, Mekinulov B. A Case Report of Cotard's Syndrome. *Psychiatry (Edgmont)*. 2008;5(6):28-29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695744/
* Grover S, Aneja J, Mahajan S, Varma S. Cotard's syndrome: Two case reports and a brief review of literature. *J Neurosci Rural Pract*. 2014;5(Suppl 1):S59-S62. doi:10.4103/0976-3147.145206 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271387/
* https://www.healthline.com/health/cotard-delusion
* Jeff Huarcaya-Victoria, Mario Ledesma-Gastañadui, and Maria Huete-Cordova, “Cotard’s Syndrome in a Patient with Schizophrenia: Case Report and Review of the Literature,” *Case Reports in Psychiatry* 2016 (2016): pp. 1-7, https://doi.org/10.1155/2016/6968409.