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Cotard Delusion

The Cotard Delusion or Cotard's Syndrome is a rare disorder in which a person holds a delusional belief they are dead, do not exist, are putrifying or have lost their blood or internal organs.

It is named after Jules Cotard (1840 - 1889) a French neurologist who first described the condition, which he called le délire de négation, in a lecture in Paris in 1880.

In this lecture, Cotard described a patient with the moniker of Mademoiselle X, who denied the existence of God, the Devil, several parts of her body and denied she needed to eat. Later she believed she was eternally damned and could no longer die a natural death.

Young and Leafhead (1996, p155) describe a modern day case of Cotard delusion in a patient who suffered brain injury after a motorcycle accident:

[The patient's] symptoms occurred in the context of more general feelings of unreality and being dead. In January, 1990, after his discharge from hospital in Edinburgh, his mother took him to South Africa. He was convinced that he had been taken to hell (which was confirmed by the heat), and that he had died of septicaemia (which had been a risk early in his recovery), or perhaps from AIDS (he had read a story in The Scotsman about someone with AIDS who died from septicaemia), or from an overdose of a yellow fever injection. He thought he had "borrowed my mother's spirit to show me round hell", and that he was asleep in Scotland.

It can arise in the context of neurological illness[?] or mental illness and is particularly associated with depression and derealisation[?].

See also: delusion, delusional disorder, psychosis

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