Cotard's syndrome in the elderly: Historical and clinical aspects

✍ Scribed by R. Luque; G. E. Berrios

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 822 KB
• Volume: 9
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.930091203

✦ Synopsis

This article explores the conceptual construction of Cotard's syndrome and includes an analysis of 100 cases of which 20 were over 65. Jules Cotard took the view that ddlire des nigations was only a subtype of depressive illness characterized by sadness, guilt, marked anxiety, suicidal behaviour, insensitivity to pain, and delusions of negation, damnation and enormity. Soon after his death, however, a debate ensued as to whether what he had described was specific to melancholia or could be found associated with other psychoses. This view predominated for more than 80 years. Currently, and despite the fact that the French term ddlire means more than 'delusion', some authors use 'Cotard's delusion' to refer to the isolated belief of 'being dead'. From clinical and evolutionary perspectives, it is unclear why an isolated delusion should merit (as some have suggested) a special brain location. Analysis of the cases so far reported suggests that it is only in the elderly that Cotard's syndrome tends to acquire its clinical completeness. There is no evidence, however, that its presence is a function of disease 'severity'.

KEY woms-Cotard's syndrome, elderly, history, clinical features.

Cotard's syndrome has survived as an occasional diagnosis, particularly in the elderly with psychotic depression. Of late, there has also been some interest in its neurobiology