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10 Case Reports of Cotard’s Delusion

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Cotard’s Delusion is a mental disorder where people suffer the nihilistic delusion that they are dead or no longer exist. First reported in the 1700s, the disorder is still largely a mystery today. The underlying cause isn’t understood; it’s been linked to bipolar disorder, depression and/or schizophrenia depending on the patient’s age. Here, ten people who went to their doctors and complained that they were dead.

1. In 1788, Charles Bonnet reported one of the earliest recorded cases of Cotard’s Delusion. An elderly woman was preparing a meal when she felt a draft and then became paralyzed on one side of her body. When feeling, movement, and the ability to speak came back to her, she told her daughters to dress her in a shroud and place her in a coffin. For days she continued to demand that her daughters, friends, and maid treat her like she was dead. They finally gave in, putting her in a shroud and laying her out so they could “mourn” her. Even at the “wake,” the lady continued to fuss with her shroud and complain about its color. When she finally fell asleep, her family undressed her and put her to bed. After she was treated with a “powder of precious stones and opium,” her delusions went away, only to return every few months.

2. Some 100 years after Bonnet met the old lady, French neurologist Jules Cotard saw a patient with an unusual complaint. Mademoiselle X, as Cotard called her in his notes, claimed to have “no brain, no nerves, no chest, no stomach and no intestines.” Despite this predicament, she also believed that she “was eternal and would live for ever.” Since she was immortal, and didn’t have any innards anyway, she didn’t see a need to eat, and soon died of starvation. Cotard’s description of the woman’s condition spread widely and was very influential, and the disorder was eventually named after him.

3. In 2008, New York psychiatrists reported on a 53-year-old patient, Ms. Lee, who complained that she was dead and smelled like rotting flesh. She asked her family to take her to a morgue so that she could be with other dead people. They dialed 911 instead. Ms. Lee was admitted to the psychiatric unit, where she accused paramedics of trying to burn her house down. After a month or so of a drug regimen, she was released with great improvement in her symptoms.

4. In 1996, a Scottish man who suffered head injury in a motorcycling accident began to believe he had died from complications during his recovery. Not long after he completed recovery, he and his mother moved from Edinburgh to South Africa. The heat, he explained to his doctors, confirmed his belief because only Hell could be so hot.

5. In 2012, Japanese doctors described a 69-year-old patient who declared to one of the doctors, “I guess I am dead. I’d like to ask for your opinion.” When the doctor asked him whether a dead man could speak, the patient recognized that his condition defied logic, but could not shake his conviction that he was deceased. After a year, his delusion passed, but he insisted on the truth of what happened during it. “Now I am alive. But I was once dead at that time,” he said. He also believed that Kim Jong-il was also a patient at the same hospital.

6. In 2009, Belgian psychiatrists reported the case of an 88-year-old man who came to their hospital with symptoms of depression. The man explained that he was dead, and was concerned and anxious that no one had buried him yet. His delusions subsided with treatment.

7. The same doctors also treated a 46-year-old woman who claimed to have not eaten nor gone to the bathroom in months, nor slept in years. She explained that all her organs had rotted, that she had no blood and that doctors who monitored her heart or took her blood pressure were deceiving her because her heart didn’t beat. After multiple admissions to the hospital and a lapse in taking her medication over the next 10 months, her condition gradually improved.

8. Greek psychiatrists received a patient in 2003 who believed he was literally empty-headed. He had attempted suicide years earlier because he thought it wasn’t worth living since he didn’t have a brain. He was not treated after the incident and simply returned to work. Once at the hospital he “claimed that he was born ‘without a mind,’ meaning that his head is empty without a brain and for this reason he is retarded.” He left against medical advice after several days, and was re-admitted the next year. This time he completed treatment and showed sustained improvement in a follow-up interview months later.

9. The Greek doctors also treated a 72-year-old woman who went to the ER claiming “all of her organs had melted; only skin had remained and that she was practically dead.” She was admitted to the hospital and her outcome not reported.

10. In 2005, Iranian doctors described what may be the most unusual case recorded. A 32-year-old man arrived at their hospital saying that not only was he dead, but that he had been turned into a dog. He said that his wife had suffered the same fate. His three daughters, he believed, had also died and had turned into sheep. He said that his relatives had tried to poison him, but that nothing could hurt him because God protected him even in death. He was diagnosed with Cotard’s and clinical lycanthropy, treated with electro-convulsive therapy and relieved of his major symptoms. (You can read more about this case at my website.)

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Knock-Off Versions of Nerf Ammo Can Cause Serious Eye Injuries
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Nerf toy guns and their foam projectiles, as marketed and manufactured by Hasbro, are virtually harmless when used as instructed. But, as reported by CNN, a recent paper in the UK medical journal BMJ Case Reports is providing a reality check when it comes to using the mock weapons and off-brand ammo improperly.

Three unrelated patients were treated at Moorfields Eye Hospital in London with ocular injuries that were sustained as a result of being "shot" with Nerf guns. Two adults had bleeding and inflammation in the eye; one 11-year-old had bleeding, inflammation, and damage to the outer retinal layer. All three suffered what the paper described as "significant ocular trauma." Attending doctors treated their swelling, and all symptoms resolved within a few weeks.

So what happened? In the case of one patient, a Nerf play session went awry as a result of using non-licensed ammo that isn't subject to Hasbro's quality control measures and may be made of harder materials as a result. On their Nerf landing page, Hasbro cautions users to "never modify any Nerf blasters or other Nerf products. Use only the darts, water, rounds, and discs designed for specific Nerf blasters."

Pediatric ophthalmologists interviewed by CNN recommend that protective eyewear be used whenever anyone is playing with Nerf weapons. It's also advisable never to aim for the face when shooting and to avoid attempting to modify the weapons to shoot faster or farther.

[h/t CNN]

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Here's What You Need to Know Before Getting Inked or Pierced, According to Doctors
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Getting inked or pierced is a rite of passage for many teens and young adults. But before getting that belly ring or butterfly on your back, experts want you to be aware of the risks, which are reviewed in a new clinical report from the American Academy of Pediatrics (AAP). According to NPR, it's the first set of recommendations the professional association has ever released on the practices.

Forthcoming in the October 2017 issue of Pediatrics and available online, the report provides a general assessment of the types and methods used to perform body modifications, along with potential health and social consequences. Here are a few main takeaways:

—It's unclear how often tattoos cause health complications, but they're generally believed to be rare, with the greatest risk being infection. One recent study found that nanoparticles in ink can travel to and linger in lymph nodes for an extended period. That said, you should check with your doctor to make sure all of your immunizations are up to date before getting either a tattoo or piercing, and that you're not taking any immunity-compromising medicines.

—Before shelling out your hard-earned cash on a tattoo, make sure it's something you'll likely still appreciate in five to 10 years, as it costs anywhere from $49 to $300 per square inch to remove a tattoo with lasers. (This might provide all the more incentive to opt for a small design instead of a full sleeve.)

—About half of people 18 to 29 years of age have some kind of piercing or tattoo, according to Dr. Cora Breuner, who is chair of the AAP committee on adolescence. Many individuals don't regret getting one, with some reporting that tattoos make them feel sexier. But while millennials appear to be cool with metal and ink, hiring managers might not be too pleased: In a 2014 survey of 2700 people, 76 percent said they thought a tattoo or piercing had hindered their chances of getting hired, and nearly 40 percent thought tattooed employees reflected poorly on their employers.

—Not all tattoo parlors are created equal, as each state has different regulations. Keep a close eye on whether your artist uses fresh disposable gloves, fresh needles, and unused ink poured into a new container. This helps prevent infection.

—The advice is similar for getting pierced: Make sure the piercer puts on new, disposable gloves and uses new equipment from a sterile container. Tongue piercings can cause tooth chippings, so be careful of that—and remove any piercings before you play contacts sports.

The full report is available online.

[h/t NPR]

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