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Cotard Syndrome (Scrubs)

Overview o First described by Dr. Jules Cotard in 1880 He called it delusion of negations (delire des negations) o Believed it to be a new kind of depression Anxiety Hypochondriac Ideas Nihilistic Delusions Belief that the body or parts thereof are dead or missing. o Somatic Type Disorder o Distinct disorder or symptom of others? Much debate within the field of psychology No listing in DSM-IV-TR for this reason Symptoms o Characteristic Symptom Nihilistic Delusions Delusion of nonexistence; a fixed belief that the mind, body , or world at large-or parts thereof-no longer exist o Comorbid Symptoms Severe Depression And/or schizophrenia Possibly leads to bi-polar disorder Causes o Biological Traumatic Brain Injury Organic Lesions of the Brain Brain Atrophy Chemical Imbalance Low serotonin leading to depression High dopamine leading to schizophrenia Genetic predisposition Causes cont. o Sociocultural Common in the homeless Society tends to ignore them Depressive and/or schizophrenic symptoms bring about belief of nonexistence Adolescents Lack attention from family at home Social outcasts in school Social Labeling Certain label requires certain behavior Treatment o New Atypical Antipsychotics More effective than traditional antipsychotics Bind not only to D-2 dopamine receptor sites but also D-1 and serotonin receptors Electroconvulsive Therapy Short mild electric shocks triggering a seizure in the brain. Sedatives, muscle relaxers and anesthesia Sulpiride and other medications with both antipsychotic and antidepressant abilities o Most effective treatment varies with basic underlying disorders Groups o 100 case study by Berrios and Luque Broke Cotards down into 3 factors Psychotic Depression Melancholia and Few Nihilistic Delusions Type I Delusion prominent in comparison to depression Type II (mixed group) Anxiety, depression, and auditory illusions Cotards Syndrome Damnation Guilt Hypochondriasis Immortaily Depression Auditory Hallucinations Visual Hallucinations Nihilistic Delusions (body) Nihilistic Delusions (concepts) Nihilistic Delusions (existence) Anxiety Cases o A case study of Cotards syndrome: stages and diagnosis Depression example o Cotards syndrome. A three case study Schizophrenic example