Cotard delusion's initial cause is thought to be pervasive dyshomeostasis (widespread dysregulation of basic bodily functions). Based on this assumption, some researchers propose that the depersonalisation experiences accompanying Cotard Syndrome result from distinct breakdowns in the brain's self-modelling process.

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Given the clinical significance of Cotard Syndrome, researchers have examined the overall clinical presentation, symptomatology, and comorbidity of this delusional disorder.

Presentation of Cotard Syndrome

When investigating Cotard Syndrome, psychiatrists have stated that the delusion “I am dead” comes to mind when a neuropathological condition has resulted in complete abolition of emotional responsivity to the world; however, despite this initial conclusion, research shows that patients with Cotard delusion are described as experiencing emotions including anxiety, fear, guilt, distress, euphoria and worry. Thus, the complete absence of emotional responsivity cannot be what prompts the delusional idea that one is dead. 


Emotional Experiences of Patients with Cotard Syndrome

Since an individual with Cotard delusion experiences nihilistic delusions concerning existence, researchers conducted a literature review and found that, despite its challenging diagnosis, there is readily available care (ie psychopathology, electroconvulsive therapy) that reduce the severity of symptoms.

Medical Components of Cotard Delusion

The Cotard delusion (CD) is characterized by nihilistic beliefs about the body’s existence or life itself. In a case study, psychologists found that a patient  believed that he was physically dead and possessed by demons for several weeks. This delusion was reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. However, his condition gradually improved over the course of treatment with Divalproex and quetiapine with discussions about the rationale for his belief. 

Symptomatology as it relates to Schizophrenia 

Cotard's Syndrome (the delusion of being dead or non-existent) can occur as a symptom of schizophrenia, and schizophrenia is itself one of the recognized causes of Cotard's Syndrome. This comorbidity is rare: fewer than 1% of individuals with schizophrenia are also diagnosed with Cotard's Syndrome. The two conditions share overlapping symptoms, most notably nihilistic delusions and ideas.

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