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Cotard delusion : ウィキペディア英語版
Cotard delusion

The Cotard delusion (also Cotard's syndrome and walking corpse syndrome) is a rare mental illness in which an afflicted person holds the delusion that they are dead, either figuratively or literally; yet said delusion of negation is not a symptom essential to the syndrome proper.〔Berrios G.E. and Luque R. (1995) Cotard's delusion or syndrome?. ''Comprehensive Psychiatry'' 36: 218–223〕 Statistical analysis of a hundred-patient cohort indicates that the denial of self-existence is a symptom present in 69 percent of the cases of Cotard's syndrome; yet, paradoxically, 55 percent of the patients might present delusions of immortality.〔Berrios G.E. and Luque R. (1995) Cotard Syndrome: Clinical Analysis of 100 Cases. ''Acta Psychiatrica Scandinavica'' 91:185–188〕
In 1880, the neurologist Jules Cotard described the condition as ''Le délire des négations'' ("The Delirium of Negation"), a psychiatric syndrome of varied severity. A mild case is characterized by despair and self-loathing, and a severe case is characterized by intense delusions of negation and chronic psychiatric depression.〔Berrios G.E. & Luque R. (1999) Cotard's 'On Hypochondriacal Delusions in a Severe form of Anxious Melancholia. ''History of Psychiatry'' 10:269–278.〕 The case of Mademoiselle X describes a woman who denied the existence of parts of her body and of her need to eat, and said that she was condemned to eternal damnation and therefore could not die a natural death. In the course of suffering "The Delirium of Negation", Mademoiselle X died of starvation.
As a mental illness, Cotard's syndrome also includes the patient's delusion that they do not exist as a person, are putrefying, and have lost blood, internal organs, or both. The Cotard delusion is not included in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM), either the DSM-IV (1994) or the DSM-IV-TR (2000) editions.〔Debruyne H., et al., "Cotard's syndrome: a review", Curr Psychiatry Rep. 2009 Jun;11(3):197–202; http://www.ncbi.nlm.nih.gov/pubmed/19470281〕 In the tenth edition of the ''International Statistical Classification of Diseases and Related Health Problems'' (ICD-10), of the World Health Organization, code F22 identifies the Cotard delusion as a disease of human health.〔Hans Debruyne, et al., "Cotard's Syndrome", Mind & Brain 2011; 2:(1). July 2011〕
==Signs and symptoms==
The delusion of negation is the central symptom in Cotard's syndrome. The patient afflicted with this mental illness usually denies their existence, or the existence of a certain body part, or the existence of a portion of their body. Cotard's syndrome exists in three stages: (i) Germination stage—the symptoms of psychotic depression and of hypochondria appear; (ii) Blooming stage—the full development of the syndrome and the delusions of negation; and (iii) Chronic stage—continued, severe delusions and chronic psychiatric depression.
The Cotard syndrome withdraws the afflicted person from other people, which includes neglecting their personal hygiene and physical health. The delusion of negation of self prevents the patient from making sense of external reality, producing a distorted view of the external world. Such a delusion of negation is usually found in the psychotic patient who also presents with schizophrenia. Although a diagnosis of Cotard's syndrome does not require the patient's having had hallucinations, the strong delusions of negation are comparable to those found in schizophrenic patients.〔Young, A.W., Robertson, I.H., Hellawell, D.J., de, P.K.W., & Pentland, B. (January 01, 1992). Cotard delusion after Brain Injury. ''Psychological Medicine'', 22, 3, 799–804.〕

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