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

The initial cause of Cotard delusion is pervasive dyshomeostasis (dysregulation of basic bodily function). Given this assumption/conclusion, some researchers argue that depersonalisation experience associated with Cotard Syndrome are produced by different breakdowns in the process of self‐modelling.

Bodily and Affective Experiences 

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 

Schizophrenia is recognized as a cause of Cotard's Syndrome, and Cotard's Syndrome is recognized as a symptom of schizophrenia. Less than 1% of those with schizophrenia get diagnosed with Cotard's Syndrome. Both schizophrenia and Cotard's Syndrome come with similar symptoms, especially nihilistic delusions and ideas.

Comorbidity of Schizophrenia and Cotard's Syndrome

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

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 In this delusional syndrome, individuals believe they have lost something important, such as status and bodily organs, amongst other possessions.

Cotard Syndrome

One way to examine or learn more about Cotard Syndrome is to study the neurological and cognitive components of the delusion disorder. 

Neuropsychological and Cognitive Components of Cotard Syndrome

References for Cotard Syndrome

During one case study, researchers found that delusion were reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. As such, it is important to study the co-occurrence of CD in schizophrenia, their differentiation, the increased risk of violence and self-harm behavior in this presentation, and how specific events and religious factors can influence delusional themes of CD. 

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