Cotard’s delusion

Cotard’s delusion


Cotard’s delusion (Cotard’s syndrome, «Walking dead syndrome», walking corpse syndrome) is a rare mental disorder in which a person mistakenly believes that he or she is dead, does not exist, putrefying. Patient claims that does not have internal organs or blood. The illness can be simply described as the denial of self-existence. Some patients may have delusions of immortality.

A medical condition is characterized by mental disorders and delusions. Most often, the syndrome appears in the case of schizophrenia or affective psychosis and often associated with temporal lesions of subdominant hemisphere of the brain and migraine attacks. Often Cotard’s delusion is the result of organic brain syndrome.

In 1880, the neurologist Jules Cotard described the condition as Le délire des négations (“The Delirium of Negation”), a psychiatric syndrome of varying severity. He described the incident which occurred with a 43-year-old patient “Mademoiselle X”, who claimed that has no brain and is dead.

Cotard’s delusion

Cotard’s syndrome is divided into three stages:

  1. Germination stage (the patient suffers from depression, worry of unwellness)
  2. Blooming stage (the full development of the disorder, delusion of being dead or immortal)
  3. Chronic stage (chronic delusions and severe depression, paranoia)

Signs and symptoms of Cotard’s delusion

  • denial of self-existence (patients believe that they are dead)
  • denial the existence of a certain body part
  • a belief that they are putrefying (patients can even smell rotting flesh) or lost vital organs
  • depression, anxiety, feeling of guilt
  • negativity and insensitivity to pain
  • neglecting of personal hygiene and physical health
  • schizophrenia, hallucinations
  • no interest to social life
  • suicidal tendency
  • distorted view of the world

Causes and risk factors:

Cotard’s delusion is caused by a malfunction in an area of the brain called fusiform gyrus, which is responsible for recognizing faces, and amygdala, a set of neurons that produce emotions. It causes the lack of recognition of familiar faces when even own face becomes unfamiliar and a person begins to be disconnected from reality.

The risk factors are depressive disorders, mental problems like schizophrenia, bipolar disorders, and dementia. Also, Cotards syndrome is associated with brain atrophy, brain tumors, brain injury, seizure disorders, stroke and Parkinson disease.


Cotard’s syndrome is diagnosed based on symptoms and patients history.

Some medical tests may be used to exclude other diseases and diagnose associated diseases. Doctors may include such tests as a blood test, MRI, CT Scan, SPECT (single-photon emission computed tomography), EEG (electroencephalogram).


Cotard’s delusion is treated by medication together with electroconvulsive therapy. Also, it is important to identify and treat risk factors of the disease.

Common treatment of Cotard’s delusion includes antidepressants, antipsychotics, and mood stabilizer medications. The person should be treated with a single drug or combination according to the case. Mood stabilizers have shown successful results for patients with bipolar disorders.

Most cases of Cotard’s delusion are more responsive to electroconvulsive treatment (ECT) than to pharmacological treatment. ECT along with antidepressants and antipsychotics have been shown to help control the symptoms much more effectively than medications alone. EC therapy is done by placing electrodes on the patient’s head and performing the small impulses.

However, more research needs to be done on this condition because scientists are still studying the cause of this disease and how to treat it.

The prognosis of recovering depends on the severity of the illness and used treatment options. Some patients were totally recovered with proper treatment and other died of starvation or suicide.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.