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A UK Case Report Describes A 59 Year Old Woman

Mughal And Menezes Published It In 2013

She Lives Alone In A Council Flat

Mental Health Services Knew Her For Depression With Somatic Features

She Presented With Worsening Somatisation And A Loss Of Mobility

Severe Back And Leg Pain Began Over Twenty Years Earlier

She Linked The Pain To A Spinal Injury From Giving Birth To Her Son

An MRI Of Her Spine Showed Only Disc Degeneration

Before 2003 She Had 14 Admissions To Hospital For These Symptoms

In The Days Before Admission She Grew Hopeless And Suicidal

The Authors Write That She Felt She Was A Rotting Corpse

They Also Write That She Expressed The Wish Of Wanting To Die

She Explained That The Blood Flow To Her Legs Was Compromised

By Her Account That Left Her Legs Rotting And Falling Off

Doctors Found Nihilistic Delusions About Her Legs

Her Blood Count And Thyroid Function Tests Were Normal

Doctors Diagnosed Severe Depression According To ICD-10

The Authors Call It Severe Depression With Cotard's Phenomenon

She Received A Course Of Twelve ECTs

After That Course Her Nihilistic Delusions Had Resolved

A Single Report Cannot Show What Is Typical

Berrios And Luque Analyzed 100 Published Cases

They Published Their Analysis In A Psychiatry Journal In 1995

These Were Case Reports And Not A Population Sample

So Every Figure Here Describes Those 100 Published Cases

Depression Was Reported In 89 Percent Of Those Cases

The Most Common Nihilistic Delusions Concerned The Body

Body Delusions Appeared In 86 Percent Of Cases

Delusions About Existence Appeared In 69 Percent

Anxiety Was Also Common At 65 Percent

Guilt Was Common At 63 Percent

Hypochondriacal Delusions Followed At 58 Percent

Delusions Of Immortality Followed At 55 Percent

The Woman In The Case Report Also Had Depression

A Different Finding Limits What Those Figures Mean

The Authors Found No Clinical Difference Between Men And Women

They Also Found None Between Diagnostic Categories

Older Age Seemed To Raise The Likelihood Of These Delusions

Case Reviews Cannot Show How Many People Have Cotard

A Later Mayo Clinic Series Added Brain Imaging

A 2018 Mayo Clinic Study Searched Its Records For Signs Of Cotard

Its Search Identified 18 Patients

Cotard Delusions Were Present In 14 Of Them

Two Of The 14 Were Under Age 18 And Were Excluded

That Left 12 Patients For The Analysis

Their Median Age Was 52 Years

The Youngest Was 30 And The Oldest Was 85

Neuroimaging Showed Frontal Lobe Changes In Four Patients

Four Patients Showed Generalized Volume Loss

Five Patients Had Ischemic Changes

Seven Had Damage On The Right Side Of The Brain Or On Both Sides

The Authors Say Cotard Occurs In A Relatively Wide Range Of Illnesses

Those Include Brain Disease And Mental Illness And Medical Illness

Depression Is Not The Only Background In The Literature

A Separate Case Report Describes A 60 Year Old Man

He Had Schizophrenia And Polysubstance Abuse

Law Enforcement Brought Him To The Hospital For Aggressive Behavior

He Expressed Paranoid And Nihilistic Thoughts And Delusions

The Authors Report His Case As Cotard's Syndrome

Published Cases Place Cotard In Depression And In Schizophrenia