A review of the phenomenology and cognitive neuropsychological origins of the cotard delusion

Cotard's delusion is characterised by a series of bizarre beliefs ranging from loss of one's organs, blood, body parts to believing that one's soul is lost or dead, even that one does not exist at all. Lying at the core of these nihilistic delusions are themes of negativism and self-accusatory depressive delusions and the paradox that, although they believe that they are dead (in extreme cases), or that they can never die, they still try to destroy themselves. Our paper reviews the epidemiology and aetiology of Cotard's delusion. The primary focus, however, is on explanatory theories, in which psychodynamic, cerebral lesion/ dysfunction and cognitive neuropsychological accounts are presented. This is a selective review in which the following key terms: Cotard's syndrome, Cotard's delusion, nihilistic delusions were used to search PsycInfo and Medline databases.