All You Need to Know About Cotard Syndrome

All You Need to Know About Cotard Syndrome

When Cotard delusion is a mental disorder. The sick patients suffer from the conviction that they are dead. The delusion is associated, for example, with the belief that one has neither blood nor organs or that they are already decaying. Cotard syndrome is a thought disorder and is considered a delusion.

What is Cotard Syndrome?

People with Cotard syndrome are convinced that they no longer exist or are dead. It is a delusional thinking disorder. The disease is often associated with psychoses such as schizophrenia. In addition, the disorder shows up in some cases with certain damage to one hemisphere of the brain and with migraines.

Many patients develop Cotard syndrome due to serious diseases of the brain. The sick people are convinced, for example, that they have neither a soul nor organs. The disease was first described by Jules Cotard and is named after him.


The causes of Cotard syndrome are many. In numerous cases, the disease occurs in connection with other mental disorders. The Cotard syndrome often shows itself, for example, in the context of schizophrenia, depression or psychosis. These disorders are primarily caused by organic damage and disorders of the brain.

For this reason, it can be assumed that Cotard syndrome is also primarily triggered by lesions in certain areas of the brain. External factors in the patient’s living conditions are often responsible for the onset of the disease.

Symptoms, ailments & signs

The symptoms of Cotard syndrome usually clearly indicate the disease. From a neurological perspective, Cotard syndrome is related to so-called Capgras syndrome. Some researchers believe that these mental disorders arise from loss of connection between different areas of the brain.

The areas of the brain that connect emotions and facial recognition are particularly relevant. The limbic system and the amygdala, for example, are responsible for this. When such connections are lost, known people are no longer recognized and do not evoke feelings of familiarity.

A similar phenomenon can also be seen in one’s own face, which is viewed in the mirror. As a result, people with Cotard syndrome suffer from the conviction that they are no longer alive. Cotard syndrome occurs in many cases together with neurological diseases and mental disorders. It is often associated with so-called derealization and general depression.

In addition, some people develop symptoms of Cotard’s syndrome as a side effect of the drug acyclovir. Doctors assume that a certain metabolite of the active substance is responsible for the development of Cotard syndrome. People who suffer from kidney weakness are particularly at risk.


The diagnosis of Cotard syndrome is usually made by a psychologist, psychiatrist, or neurologist. Usually several specialists are involved in diagnosing the disease. Basically, a diagnosis of Cotard’s syndrome is often difficult because the patients do not always cooperate and do not show any insight into the disease. This often results in a long ordeal before Cotard’s syndrome is diagnosed and treated accordingly.

If people suspect that they have Cotard syndrome, they should first contact their general practitioner. They refer the patient to a specialist in mental disorders and neurological diseases. The medical history is usually carried out by a psychologist. The detection of other disorders in the respective person plays an important role, such as schizophrenia or depression.

On the basis of the descriptions of the sick patient, the suspicion often falls quickly on the Cotard syndrome. Neurologists usually study the organic basis of the disease. For example, brain imaging techniques are used for this purpose. This makes it possible to identify anomalies in the connection between different areas of the brain and unusual or absent emotional reactions.


Cotard syndrome is a very serious condition and requires urgent medical attention. In most cases, the patient behaves callous and very dismissive. It is no longer possible to assign familiar people or faces, which is associated with very strong social and psychological problems.

As a rule, the person concerned can no longer recognize his or her own face. Thinking about one’s own death and decomposition leads to severe depression, so that normal everyday life is no longer possible. In most cases, the patient denies that he has Cotard’s syndrome, resulting in a very lengthy and difficult treatment.

In the worst case, depression and withdrawal can lead to death. The treatment itself is carried out by a psychologist. If the patient acts dangerously, the treatment can also be carried out in a closed clinic. In most cases, Cotard syndrome is treated with psychotherapy and medication.

However, it can take several months for the treatment to have a positive effect. Due to the Cotard syndrome, it is often no longer possible for those affected to pursue a regular job.

When should you go to the doctor?

Usually, Cotard syndrome needs to be treated by a doctor. Since this is a very strong and serious mental disorder, in most cases there is no self-healing, so diagnosis and treatment by a doctor is definitely necessary. A doctor should be seen if the person is convinced that they are dead. Other thinking disorders can also indicate the disease and should be examined by a psychologist.

An examination by a doctor must also be carried out if the patient can no longer correctly recognize or identify emotions or other faces due to Cotard syndrome. Kidney weakness can also occur, so this organ should be checked. Diagnosis of Cotard syndrome is usually made by a general practitioner. For further treatment, however, a visit to a special clinic is recommended. It cannot be universally predicted whether the treatment of Cotard syndrome will result in a positive outcome.

Treatment & Therapy

As a rule, various methods are used in the treatment of Cotard syndrome. On the one hand, the patients receive intensive psychotherapeutic care in which the underlying disorder is analyzed. The life situation and past of the patient are also discussed and processed.

In addition, psychotropic drugs are also prescribed for some people in order to influence the organic factors favorably in the development of the delusions. In drug therapy for Cotard’s syndrome, active ingredients from the groups of neuroleptics and antidepressants are primarily used.

In addition, empirical values ‚Äč‚Äčindicate that electroconvulsive therapies have a beneficial effect on the administration of medication for the treatment of Cotard’s syndrome. The prognosis of Cotard syndrome mostly depends on the type and severity of the associated mental disorders as well as the quality and course of treatment.

Outlook & forecast

With Cotard syndrome, the outlook and prognosis are based on whether there are other mental illnesses and the intensity of the symptoms of Cotard syndrome. In mild cases, the symptoms can be alleviated by psychotherapeutic treatment and medication. Many patients are symptom-free after completing therapy and are also not at risk of relapse. However, if the person concerned suffers from other emotional complaints, the Cotard syndrome can persist for years.

Drug treatment promises to alleviate symptoms, but the patient’s mental state improves only slowly. If Cotard syndrome occurs as part of a serious mental illness such as schizophrenia, the prognosis is rather poor. The suffering can be reduced, for example, with neuroleptics and antidepressants, but here, too, no long-term improvement is possible unless the underlying disease is dealt with and dealt with as part of comprehensive psychotherapeutic measures.

With Cotard syndrome, there is an increased risk of further psychological ailments developing. Some patients become depressed or have severe mood swings and anxiety as a result of increased numbness.


Concrete preventive measures are difficult with regard to Cotard syndrome, as with many other mental disorders. The Cotard syndrome occurs more often in connection with depression as well as psychosis and schizophrenia. Such diseases can also only be prevented to a limited extent. Often there is a genetic component that promotes an outbreak of mental illness in unfavorable living conditions.

Although effective prevention of Cotard’s syndrome is not straightforward, there are effective methods of therapy. Family members or confidants of the patient will help ensure that they seek medical treatment as early as possible.


In most cases, the person affected with Cotard syndrome does not have any special follow-up measures available. This mental illness must first and foremost be treated comprehensively by a doctor so that there are no further complications. The symptoms can only be relieved permanently through correct and professional treatment, as this usually does not lead to an independent healing.

In most cases, the person’s family or friends need to point out the symptoms of Cotard’s syndrome and persuade them to seek treatment. Treatment can also take place in a closed clinic if the syndrome is severe. The disease cannot always be treated completely.

The disease can also be treated by taking medication. The person concerned must ensure that it is taken correctly and regularly, whereby the correct dosage must also be observed. As a rule, the behavior that led to the symptoms of Cotard syndrome must also be avoided. The further course depends very much on the severity of the disease, so that no general prediction can be made.

You can do that yourself

Since the disturbances and complaints in the Cotard syndrome are very strong, the sick person is often not able to help himself to a sufficient extent. He is dependent on outside help. If possible, he should build a stable environment so that he can get support at all times.

With this disease, the main focus is on sufficient self-help for close relatives. They are well advised to find out more about the symptoms of the disease so that they do not find themselves in a sudden situation of excessive stress. Since their influence to alleviate the symptoms is only possible to a limited extent, they should concentrate on a good way of caring for the sick person. In doing so, they give up responsibility and can try to find their own balance. Relatives are encouraged to take care of themselves and not neglect their own wellbeing.

A good social network helps you cope with everyday life, as tasks can be distributed and mutual support is possible. Mental health is a priority for relatives. If you are caring for the sick person, it is advisable that you plan stress-reducing activities in your own leisure time. Relaxation techniques, a healthy lifestyle or an exchange with like-minded people can strengthen your own well-being.

Cotard Syndrome