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OKAY BACK FROM THE ER 🚑

A Case Report From 2008 Describes A Woman Known As Ms. L

At 53 She Had Come From The Philippines

Only A Month Earlier She Had Moved To The US

Her Family Called 911 Because Of What She Was Saying

She Was Complaining That She Was Dead

In Her Words She Smelled Like Rotting Flesh

She Wanted A Morgue So She Could Be With Dead People

Doctors Admitted Her To A Psychiatric Unit

In The Hospital She Said Paramedics Were Trying To Burn Down Her House

She Admitted To Hopelessness And Low Energy

Her Appetite Was Down And She Was Sleepy

Doctors Ruled Out Medical Causes First

Then They Started Her On Quetiapine And Bupropion

At First She Was Reluctant To Take Medication Or Eat

Her Potassium And Sodium Levels Dropped Too Low

She Needed Them Replaced Through An IV

A Few Days Later She Had An Episode That May Have Been A Seizure

Doctors Took Her Off Bupropion After That Episode

Her Medicines Became Olanzapine And Escitalopram And Lorazepam

Over One Month On Those Three Her Symptoms Improved

At Discharge She Denied The Delusions That Brought Her In

She Said She Was Hopeful About Her Future

Ms. L's Case Report Defines Cotard Syndrome As A Range Of Delusions

At One End A Person Believes They Have Lost Organs

Some People Say They Have Lost Blood Or Body Parts

At The Other End A Person Insists They Have Lost Their Soul

Others At That End Insist They Are Already Dead

Being Dead Was The Belief Ms. L Described

A 2007 Report In The British Medical Journal Calls It Rare

It Describes Strong Delusions Of Being Dead

The Condition Also Goes By The Name Walking Corpse Syndrome

A 2024 Case Report Uses That Name In Its Title

One Study Counted How Often It Turned Up In A Hospital

The Hospital Was A Neurology Referral Center In Mexico

Researchers Reviewed 1,321 Inpatient Consultations There

They Split The Patients Into Neurological And Psychiatric Groups

One Patient In The Neurological Group Had Cotard Syndrome

That Was 0.11 Percent Of The Neurological Patients

The Same Patient Also Had A Viral Brain Infection

Three Patients In The Psychiatric Group Had It

Those Three Were 0.62 Percent Of The Psychiatric Group

Both Figures Come From A Single Hospital

The Syndrome Takes Its Name From A French Doctor Named Jules Cotard

In 1880 He Reported A Clinical State He Believed Was New

His Label For It Was A New Type Of Agitated Melancholia

Patients Typically Believe They Are Dead Or Their Organs Are Rotting

Cotard Called It A Delusion Of Negations In French

Some Later Papers Including Ms. L's Give The Year As 1882

The British Medical Journal Report Simply Says The 1880s

A Later Review Of Published Cases Also Opens With 1880

Its Analysis Found Three Patterns Among Those Cases

The Review Says Authors Mostly Call It A Syndrome Not A Disease

A 2016 Case Report From Brazil Checked Two Diagnostic Manuals

One Was The DSM-5 Diagnostic Manual

The Other Was The ICD-10 Disease Classification

Neither Manual Lists Cotard Syndrome As A Disorder Of Its Own

Under The DSM-5 Their Patient Would Count As Psychotic Depression

The Belief In Being Dead Is Filed As One Symptom Of That Episode

Doctors Still Use The Name Cotard In Published Case Reports

Ms. L's Own Case Report Has The Name In Its Title