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Cotard's syndrome, also known as Cotard's delusion or walking corpse syndrome, is a rare mental disorder in which the affected person holds the delusional belief that they are deceased, do not exist, are putrefying, or have lost their blood or internal organs.

Statistical analysis of a hundred-patient cohort indicated that denial of self-existence is present in 45% of the cases of Cotard's syndrome; the other 55% of the patients presented with delusions of immortality. In 1880, the neurologist and psychiatrist Jules Cotard described the condition as le délire des négations ("the delusion of negation"), a psychiatric syndrome of varied severity. A mild case is characterized by despair and self-loathing, while a severe case is characterized by intense delusions of negation, and chronic psychiatric depression. The case of "Mademoiselle X" describes a woman who denied the existence of parts of her body (somatoparaphrenia) and of her need to eat. Cotard's syndrome is not mentioned in either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the 10th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization.

Delusions of negation are the central symptom in Cotard's syndrome. Although a diagnosis of Cotard's syndrome does not require the patient to have had hallucinations, the strong delusions of negation are comparable to those found in schizophrenic patients.

The article Betwixt Life and Death: Case Studies of the Cotard Delusion (1996) describes a contemporary case of Cotard's syndrome which occurred in a Scotsman whose brain was damaged in a motorcycle accident: The article Recurrent Postictal Depression with Cotard Delusion (2005) describes the case of a 14-year-old epileptic boy who experienced Cotard's syndrome after seizures.

The underlying neurophysiology and psychopathology of Cotard's syndrome might be related to problems of delusional misidentification. Neurologically, Cotard's syndrome (negation of the self) is thought to be related to Capgras delusion (people replaced by impostors); each type of delusion is thought to result from neural misfiring in the fusiform face area of the brain, which recognizes faces, and in the amygdalae, which associate emotions to a recognized face. If the patient sees their own face, they might perceive no association between the face and their own sense of self⁠—which results in the patient believing that they do not exist (Cotard's syndrome). Cotard's syndrome is usually encountered in people with psychosis, as in schizophrenia. As such, Cotard's syndrome patients present a greater incidence of brain atrophy—especially of the median frontal lobe—than do people in control groups. The occurrence of Cotard's syndrome symptoms was associated with a high serum-concentration of 9-carboxymethoxymethylguanine (CMMG), the principal metabolite of acyclovir. Hemodialysis resolved the patient's delusions (of negating the self) within hours of treatment, which suggests that the occurrence of Cotard's syndrome symptoms might not always be cause for psychiatric hospitalization of the patient.

It is speculated that Per "Dead" Ohlin, lead vocalist for the black metal bands Mayhem and Morbid, had Cotard's syndrome as a result of an assault by bullies in his youth that left him clinically dead for a short time. In series four of the BBC crime drama series Luther, protagonist DCI John Luther trails a cannibalistic serial killer with Cotard's syndrome. In season one, episode 10, of the NBC television series Hannibal, protagonist Will Graham trails a killer with Cotard's syndrome. In season four, episode 14, of the TV series Scrubs, a patient who is said to have Cotard's syndrome believes that he died years earlier. The 2016 Will Wood and the Tapeworms album Self-Ish contains the song "Cotard's Solution (Anatta, Dukkha, Anicca)", referencing Cotard's syndrome. The author Esmé Weijun Wang used to suffer from Cotard's syndrome, and her experience of the condition is a key element of her essay collection The Collected Schizophrenias.

Quick Facts

• Statistical analysis of a hundred-patient cohort indicated that denial of self-existence is present in 45% of the cases of Cotard's syndrome; the other 55% of the patients presented with delusions of immortality.
• Cotard's syndrome is not mentioned in either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the 10th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization.
• The 2016 Will Wood and the Tapeworms album Self-Ish contains the song "Cotard's Solution (Anatta, Dukkha, Anicca)", referencing Cotard's syndrome.
• In 1880, the neurologist and psychiatrist Jules Cotard described the condition as le délire des négations ("the delusion of negation"), a psychiatric syndrome of varied severity.
• In season four, episode 14, of the TV series Scrubs, a patient who is said to have Cotard's syndrome believes that he died years earlier.

Source material: Wikipedia - "Cotard's syndrome". Adapted and summarized for DiscoverScroll. Original contributors are credited through the linked Wikipedia article. Read original on Wikipedia. CC BY-SA 4.0. Changes were made from the original.