Lexicon of Madness -- Cotard's Syndrome

Cotard's Syndrome: Also called nihilistic delusional disorder. First described by 19th Century French psychiatrist Jules Cotard. The patient with Cotard's Syndrome is preoccupied with having lost status, possessions, or even internal organs. A patient might claim to have been bankrupted, evicted from his home, or abandoned by his family. He is not reassured when presented with evidence to the contrary. A patient might ask for his apparently healthy arm to be amputated surgically because "it's dead and rotting -- I can't stand the smell." He might believe that he himself has died and that clinicians are playing a mean trick on him by not burying him in a timely manner. Cotard delusions are usually associated with schizophrenia or psychotic depression. In the case of psychotic depression, electroconvulsive therapy (ECT) is indicated. Chronic Cotard's delusion may reflect the presence of a dementing syndrome such as Alzheimer's dementia.