Cotard syndrome is a mental disorder. Suffering patients suffer from the belief that they are dead. The delusion is associated, for example, with the belief that they have no blood or organs or that they are already decomposing. Cotard syndrome belongs to thought disorders and is considered a delusion.
What is Cotard’s syndrome?
Individuals suffering from Cotard’s syndrome are convinced that they no longer exist or are dead. It is a delusional thinking disorder. The disease often occurs in conjunction with psychoses such as schizophrenia. In addition, the disorder sometimes manifests itself in certain cases of damage to one hemisphere of the brain, as well as in migraine attacks. In numerous patients, Cotard’s syndrome develops as a result of serious diseases of the brain. For example, the affected persons are convinced that they do not have a soul or organs. The disease was first described by Jules Cotard and is named after him.
Causes
The causes of Cotard syndrome are varied. In numerous cases, the disorder occurs in association with other mental disorders. Often, for example, Cotard syndrome presents in the context of schizophrenia, depression, or psychosis. These disorders are primarily caused by organic damage and disorders of the brain. For this reason, it can be assumed that Cotard’s syndrome is also triggered primarily by lesions in certain areas of the brain. In addition, external factors in the patients’ life circumstances are often responsible for the onset of the disease.
Symptoms, complaints, and signs
The symptom pattern of Cotard syndrome usually clearly indicates the disease. From a neurological perspective, Cotard syndrome is related to the so-called Capgras syndrome. Some researchers believe that these mental disorders result from the loss of connectivity between different areas of the brain. Of particular relevance are those areas of the brain that link emotions and facial recognition. For example, the limbic system as well as the amygdala are responsible for this. When such connections are lost, familiar people are no longer recognized and do not evoke feelings of familiarity. A similar phenomenon can be seen when looking at one’s own face in the mirror. As a result, individuals suffering from Cotard’s syndrome suffer from the conviction that they are no longer alive. Cotard’s syndrome occurs in many cases together with neurological diseases and mental disorders. It is often also associated with so-called derealization and general depression. In addition, some people develop symptoms of Cotard’s syndrome as a side effect of the drug aciclovir. Doctors believe that a particular metabolite of the drug is responsible for the development of Cotard’s syndrome. People who suffer from kidney weakness are particularly at risk.
Diagnosis
The diagnosis of Cotard syndrome is usually made by a psychologist, psychiatrist, or neurologist. Usually, several specialists are involved in diagnosing the disease. Basically, a diagnosis of Cotard’s syndrome is often difficult because patients do not always cooperate and do not show insight into the disease. This often results in a long ordeal until Cotard’s syndrome is diagnosed and treated appropriately. If people suspect Cotard’s syndrome in themselves, the general practitioner should be contacted first. The latter refers the patient to a specialist in mental disorders and neurological diseases. The medical history is usually taken by a psychologist. The recognition of other disorders in the respective person plays an important role, such as schizophrenia or depression. Based on the descriptions of the ill patient, the suspicion often quickly falls on Cotard’s syndrome. Neurologists usually investigate the organic basis of the disease. For this purpose, imaging techniques of the brain are used, for example. This reveals abnormalities in the connection of different brain areas and unusual or absent emotional reactions.
Complications
Cotard syndrome is a very serious condition and requires urgent medical attention. In most cases, patients behave callously and are very dismissive.It is no longer possible to associate familiar people or faces, which is associated with very severe social and psychological problems. Even the own face is usually no longer recognized by the affected person. Due to thinking about one’s own death and decomposition, strong depression sets in, so that an ordinary everyday life is no longer possible. In most cases, the patient denies that he is suffering from Cotard’s syndrome, which leads to a very long and difficult treatment. In the worst case, the depression and withdrawal lead to death. The treatment itself is carried out by a psychologist. If the patient acts dangerously, the treatment can also be carried out in a closed clinic. In most cases, Cotard’s syndrome is treated with psychotherapy and medication. However, it may take several months for the treatment to have a positive effect. Due to Cotard’s syndrome, it is often no longer possible for the affected person to pursue regular work.
When should you see a doctor?
As a rule, Cotard’s syndrome must be treated by a doctor. Since it is a very severe and serious mental disorder, in most cases it also does not cure itself, so diagnosis and treatment by a doctor is definitely necessary. A doctor should be consulted when the affected person is convinced that he is dead. Other thought disorders may also indicate the disease and should be examined by a psychologist. An examination by a physician must also be done if the patient can no longer recognize or place emotions or other faces correctly due to Cotard’s syndrome. Kidney weakness may also be present, so this organ should be checked. Cotard’s syndrome is usually diagnosed by a general practitioner. However, for further treatment, a visit to a specialized clinic is recommended. It cannot be universally predicted whether there will be a positive outcome with treatment of Cotard syndrome.
Treatment and therapy
Various methods are usually used in the therapy of Cotard syndrome. On the one hand, patients receive intensive psychotherapeutic care in which the underlying disorder is analyzed. The patient’s life situation and past are also discussed and worked through. In addition, psychopharmaceuticals are prescribed for some individuals in order to favorably influence the organic factors for the development of the delusions. Drug therapy for Cotard’s syndrome primarily involves the use of agents from the neuroleptic and antidepressant groups. In addition, empirical data indicate that electroconvulsive therapies have a beneficial effect on the administration of drugs for the treatment of Cotard’s syndrome. The prognosis of Cotard syndrome usually depends on the type and severity of associated mental disorders and the quality and course of treatment.
Outlook and prognosis
In Cotard syndrome, the outlook and prognosis are based on whether other mental disorders are present and the intensity of Cotard syndrome symptoms. In mild cases, symptoms can be relieved by psychotherapeutic treatment and the administration of medication. Many patients are symptom-free after completing therapy and also have no risk of relapse. However, if the affected person suffers from further psychological complaints, Cotard’s syndrome can persist for years. Although drug treatment promises symptom relief, the patient’s mental state improves only slowly. If Cotard’s syndrome occurs in the context of a serious mental illness, such as schizophrenia, the prognosis is rather poor. The condition can be reduced, for example, by neuroleptics and antidepressants, but here, too, long-term improvement is not possible unless the causative illness is worked through and treated as part of comprehensive psychotherapeutic measures. In Cotard’s syndrome, there is an increased risk of developing other mental health conditions. Some patients become depressed or suffer from severe mood swings and anxiety as a result of increasing numbness.
Prevention
Specific preventive measures are difficult with regard to Cotard syndrome, as with many other mental disorders.Cotard’s syndrome is often associated with depression, psychosis and schizophrenia. Such diseases can also only be prevented to a limited extent. There is often a genetic component that promotes the onset of the mental illness in unfavorable life circumstances. Although effective prevention of Cotard’s syndrome is not readily available, effective methods of therapy do exist. Family members or confidants of the patient help to ensure that the patient seeks medical treatment as early as possible.
Follow-up
In most cases, no special measures of aftercare are available to the person affected by Cotard syndrome. In this regard, this mental illness must first and foremost be treated comprehensively by a physician to prevent further complications. Only through proper and professional treatment can the symptoms be permanently alleviated, as this usually does not lead to an independent cure. In most cases, the relatives or friends of the affected person must point out the symptoms of Cotard’s syndrome and persuade them to undergo treatment. In this case, the treatment can also take place in a closed clinic if the syndrome is severe. It is not always possible to treat the disease completely. The disease can be treated by taking medication. The affected person must thereby pay attention to a correct and regular intake, whereby also a correct dosage must be observed. As a rule, the behavior that led to the symptoms of Cotard’s syndrome must also be avoided. The further course depends thereby very strongly on the expression of the illness, so that thereby no general prediction can take place.
This is what you can do yourself
Since the disorders and complaints in Cotard syndrome are very strong, the sufferer is often unable to help himself to a sufficient extent. He is dependent on outside help. If it is possible, he should build up a stable environment so that he can get support at any time. The main focus in this disease is on sufficient self-help of the close relatives. They are well advised to inform themselves comprehensively about the symptoms of the disease so that they do not find themselves in a sudden situation of being overwhelmed. Since their influence to alleviate the symptoms is limited, they should focus on a good way to care for the ill person. In doing so, they relinquish responsibility and can strive for their own compensation. Relatives are encouraged to take care of themselves and not neglect their own well-being. A good social network helps in coping with everyday life, as tasks can be distributed and mutual support is possible. Mental health is a priority for family members. Should they care for the ill person, it is advisable for them to plan stress-reducing activities in their own leisure time. Relaxation techniques, a healthy lifestyle or an exchange with like-minded people can strengthen their own well-being.
