The Cotard delusion or Cotard’s syndrome or Walking Corpse Syndrome is a rare neuropsychiatric disorder in which people hold a delusional belief that they are dead (either figuratively or literally), do not exist, are putrefying, or have lost their blood or internal organs. In rare instances, it can include delusions of immortality (mutually excluding the possibility of such a condition of death as an oblivion, unless regarded as just oneself to another or others).
Treatment is difficult, and tricyclic and serotoninergic antidepressant drugs have shown little efficacy. Treatment with antidepressants, however, is a potentially viable option which could prove effective in conjunction with other remedies. Electroconvulsive therapy has shown greater promise, “curing” Cotard’s sufferers in five studies of its efficacy with that treatment. Dialectical behavior therapy and other talking cures might prove to be more effective, especially because this disorder for some is as much cognitive, linguistic and/or intellectual as it is biological.
Young and Leafhead 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 (also known as sepsis or septicemia – 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 she was asleep in Scotland.
The syndrome is named after Jules Cotard (1840–1889), a French neurologist who first described the condition, which he called le délire de négation (“negation delirium”), in a lecture in Paris in 1880. He described the syndrome as having degrees of severity that range from mild to severe. Despair and self-loathing characterize a mild state.
In this lecture, Cotard described a patient with the pseudonym of Mademoiselle X, who denied the existence of God, the Devil, several parts of her body, and her need to eat. Later she believed she was eternally damned and could no longer die a natural death. She later died of starvation.