What Causes Cotard’s Delusion? Main 3 Stages

Mental Disorders


Cotard delusion is an uncommon mental disease named after Jules Cotard (1840–1899), a French neurologist. After encountering a female patient who believed her organs didn’t exist and that her skin and bones were rotting, he characterized this disease in 1880.

The syndrome is known as délire des négations, which translates to nihilistic delusion, according to Jules Cotard. This is a strange, rare mental disorder characterized by the hallucination of non-existence as a symptom.

Cotard’s patient didn’t believe in God or the Devil. She didn’t feel she had a soul and couldn’t die naturally.

She also believed she didn’t need to eat in order to live.

The presence of a delusion of death is not required for this disorder, which is also known as the walking corpse syndrome. Patients may have delusions of being non-existent or immortal at times.

The delusion of non-existence, also known as self-negation, is more common than the hallucination of immortality. It’s worth noting that the Cotard delusion isn’t listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), IV-TR.


There are three stages to this condition. The germination stage is the initial step in the process. Symptoms are linked to hypochondria and psychotic depression at this stage.

The patient develops the delusion of non-existence or self-negation in the second stage. Psychiatric depression and delusions become more acute in the third stage.

This illness is thought to be caused by issues with the amygdala and fusiform gyrus in the brain. The amygdala serves as an emotional center, whereas the fusiform gyrus aids in face recognition.

If there is misfiring of neurons in the fusiform gyrus, the capacity to receive social, emotional, and expressive cues can be harmed. As a result, the person affected may feel disconnected from reality.

The following symptoms or signs of Cotard delusion may be experienced by those who are affected:

  • Anxious sadness Depression Believing one is dead
  • Believing one is immortal or cannot die
  • Belief that one does not exist
  • Belief that one’s organs are absent
  • Suicide or self-mutilation as a habit

A study looked at 100 cases of Cotard delusion. This syndrome has been discovered to affect both males and women. 89 percent of the participants said they were depressed.

In 65 percent of the cases, anxiety was noted, whereas in 63 percent of the cases, guilt was reported. Delusions of immortality and hypochondriacal delusions were seen in 58 percent and 55 percent of the cases, respectively.

In roughly 86 percent of the cases, delusions regarding the body were seen, whereas delusions about one’s own existence were documented in 69 percent of the cases.

Some of the people who were affected had a few delusions about non-existence, melancholia, and psychotic despair, while others were primarily deluded. Patients have reported auditory hallucinations, anxiety, depression, and other symptoms.

As a result, it’s critical to thoroughly examine the symptoms before deciding on a treatment plan.

This syndrome has been noticed in people who have been diagnosed with one or more of the following conditions:

  • Derealization
  • Psychosis
  • Neurological disorders
  • Mental illness
  • Psychosis
  • Clinical depression 

First Known Cases of Cotard Delusion

✦ The symptoms were first documented by Charles Bonnet in 1788, and the illness was named after Jules Cotard in 1880. This was a case of an elderly woman who became paralyzed and developed this disease.

She compelled her daughters to put her in a casket because she felt she was dead. She even requested that her family mourn her as she felt she had died.

✦ Another case involves a Scottish guy who began to believe he was dead after sustaining brain injuries in a motorcycle accident in 1996. He and his mother moved from Edinburgh to South Africa after recovering from the accident.

He equated the heat of South Africa to hell and believed he was burning there.

The patient in a case reported by Greek psychiatrists in 2003 had previously committed suicide because he believed he was retarded and lacked a brain. He did not receive therapy and was re-admitted.

Following treatment, his condition improved.

✦ Ms. Lee, a 53-year-old patient, was taken to a New York psychiatric institution in 2008 after complaining of being dead and telling her family that she smelled like decaying flesh. She even claimed that the paramedics were attempting to set fire to her home.

✦ Belgian psychiatrists reported in 2009 on the instance of an 88-year-old man who thought he was dead. The patient displayed depressive symptoms.

He expressed his dissatisfaction with the fact that he had not been laid to rest.

The majority of these patients’ conditions improved when they received effective therapy. Antidepressants are used to treat Cotard delusion, however electroconvulsive therapy has been shown to be effective in a number of patients.

When electroconvulsive therapy is used, a seizure is triggered in a specific area of the brain, causing the patient to lose consciousness and convulse for 15 seconds. This therapy has also been shown to help those with mental diseases like depression, bipolar disorder, and schizophrenia.

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Hi, I'm Laura and welcome to my blog.

I've been interested in the human mind since I was a child and that's the reason why I became a psychologist. I thought I had everything figured out, but it turned out I was suffering from anxiety for at least ten years without even noticing it. With the help of what I already knew, and some of my friends/colleagues, I compiled a list of articles that helped me go through my anxiety and get to the other side of the tunnel.

Thanks for stopping by, and I hope you find something to help you along the way.