Walking corpse syndrome
Description
Cotard's delusion, sometimes known as "walking corpse syndrome," is a relatively uncommon mental illness in which a person feels as though they are dead, nonexistent, decaying, or have lost their internal organs or blood.
● Key features:
➣The main symptom is delusion of negation, in which the sufferer rejects their own existence or thinks that certain bodily parts are decaying or absent.
➣Depersonalisation is the state of being cut off from oneself.
➣Severe mood disorders frequently co-occur with depression and anxiety.
➣Symptoms of psychosis: May coexist with severe depression, bipolar disease, or schizophrenia.
●Causes & associations:
➣ Severe depression (particularly withith psychotic features)
➣Neurological conditions (e.g., brain stroke, multiple sclerosis, epilepsy, dementia, and brain injury) ➣Psychotic disorders (schizophrenia, bipolar disorder)
➣According to neuroimaging research, the parietal and frontal lobes—two brain areas linked to emotional processing and self-perception—may be involved.
●Diagnosis:
There is no particular test for it; instead, a clinical examination is used to make the diagnosis (psychiatric evaluation, ruling out neurological reasons).
●Treatment:
Treatment is based on the underlying cause and can involve the following because it frequently coexists with other neurological or mental conditions
➣Antidepressants
➣Antipsychotics
➣Mood stabilizers
➣Electroconvulsive therapy (ECT): Often cited as beneficial, particularly for severe depression with Cotard's delusion
Protocol
Issues That Nurses Face
1. Suicide or self-harm risk
Patients may hurt themselves in an effort to "prove" they are dead.
It is frequently necessary to observe continuously.
2. Refusing to eat, drink, or take medication
the conviction that their body is already dead or that digestion is impossible.
causes dehydration, malnourishment, or refusal with therapy.
3. Poor self-care and personal hygiene
The patient might not perceive the need to dress, bathe, or use the loo.
4. Barriers to communication
Reasoning becomes challenging when deluded belief is strong.
Carers may not be trusted by the patient.
5. Emotional strain on employees It can be upsetting and stressful to care for someone who rejects their own existence.
Nursing Interventions & Protocols
1. Management of Safety
Put in a low-stimulus, secure setting.
Keep a watchful eye out for suicidal thoughts or attempts.
Get rid of anything sharp or that might cause ligature injuries.
2. Essential Requirements Encouragement
Encourage and support the consumption of meals and liquids.
Track your weight, electrolytes, and hydration.
Encourage ADLs (activities of daily living) such as toileting, grooming, and hygiene.
3. Adherence to Medication
Make sure that antidepressants, antipsychotics, or mood stabilisers are administered as directed.
To establish trust, employ therapeutic conversation and keep an eye out for rejection.
4. Therapeutic Interaction
Avoid confronting delusions head-on and instead practise empathic listening.
Say something like, "I know you feel like your body isn't working, but let's have some water together," to acknowledge feelings without feeding the delusion.
To increase collaboration, establish a rapport.
Notes
Indian Journal of Psychiatric Nursing 13(1):p 51-52, January 2017. | DOI: 10.4103/2231-1505.262345