Jules Cotard

Visit facepain.org. [upbeat music] This is Christine Cliatt-Brown from the University of Utah.

Today in our series on delusional misidentification syndromes, we're going to explore Cotard syndrome.

Cotard syndrome is a nihilistic delusion in which patients believe that they are dead, dying, rotting, no longer exist, are missing internal organs, or have lost their blood, soul, or body.

This presentation can vary from severe depressive nihilism to bizarre fixed somatic beliefs, but the core feature is this profound denial of self, life, or bodily existence.

The syndrome is named for Jules Cotard, a French neurologist and psychiatrist who described what he called le délire de négation in the late 19th century.

His original patient claimed she had no brain, no nerves, no chest, no stomach, and no need to eat because she was already dead.

Cotard syndrome is often discussed in psychiatry, especially in the setting of severe depression with psychotic features.

But neurologists should know that it also appears in a range of neurologic disorders.

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In 1879, a forty-five-year-old father and husband only known as MC is brought into Dr. Jules Cotard's office in Vanves, just outside of Paris.

For years, MC, who's described as healthy and strong, has lived what Cotard calls a regular and industrious life.

He has no vices except he works far too much.

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Now jumping back to Dr. Jules Cotard and the discovery of this syndrome, I'm going to set the scene.

The 1880s were a pivotal era in mental health treatment, and the time before this, people who were suffering from mental illness were often seen as subhuman.