Cotard's syndrome: analysis of 100 cases
Type of Spiritual Experience
Cotard's syndrome is an almost permanent out of body state.
It seems somewhat unforgivable that the cause of these symptoms were not investigated, as although both anxiety and depression can cause OBEs, so can brain tumours and strokes, and you might get pretty depressed if a psychologist was hauled in to 'help', when you wanted to find out why it was happening.
After all, all these 100 people knew what was happening, they didn't need a psychiatrist to tell them that.
A description of the experience
Acta Psychiatr Scand. 1995 Mar;91(3):185-8. Cotard's syndrome: analysis of 100 cases. Berrios GE1, Luque R. 1Department of Psychiatry, University of Cambridge, United Kingdom.
…. A statistical analysis has been carried out of 100 cases of Cotard's syndrome to determine how this clinical concept has fared since its inception.
In terms of clinical profile, no difference was found between men and women or between underlying diagnostic categories; age seemed to increase the likelihood of developing délire des négations.
- Depression was reported in 89% of subjects; the most common nihilistic delusions concerned the body (86%) and existence (69%).
- Anxiety (65%) and guilt (63%) were also common, followed by hypochondriacal delusions (58%) and delusions of immortality (55).
An exploratory factor analysis extracted 3 factors: psychotic depression, Cotard type I and Cotard type II. The psychotic depression factor included patients with melancholia and few nihilistic delusions.
Cotard type 1 patients, on the other hand, showed no loadings for depression or other disease and are likely to constitute a pure Cotard syndrome whose nosology may be closer to the delusional than the affective disorders.
Type II patients showed anxiety, depression and auditory hallucinations and constitute a mixed group.
This new grouping cuts across the more traditional view and may have therapeutic implications. Authors, in general, have considered délire des négations as a syndrome rather than a new disease and do not seem to support the view that the completeness of the syndrome is a function of presence or severity of depression. The view that délire des négations refers only to the delusion of being dead has also carried little favour as its likely to waste information.