Location
Philadelphia, PA
Start Date
17-4-2026 1:30 PM
End Date
17-4-2026 2:30 PM
Description
Introduction: Cotard’s syndrome is a rare neuropsychiatric condition characterized by nihilistic delusions including beliefs that one is dead, does not exist, has lost internal organs, blood, or body parts. It was first described by Jules Cotard in 1880.The syndrome was associated with melancholic anxiety, delusions of damnation, reduced pain sensitivity, and increased risk of self-harm and suicidality. Although it is not recognized as a formal diagnostic entity in the DSM-5 or ICD-11, Cotard’s syndrome occurs in association with a variety of psychiatric and neurological disorders.¹
Objective: The objective of this presentation is to review the clinical characteristics, associated psychiatric and neurological conditions, and demographic patterns reported in the literature on Cotard’s syndrome.
Methods: A narrative literature review was conducted using peer-reviewed publications describing Cotard’s syndrome. Key articles, including clinical reviews and case analyses, were examined to identify common clinical features, associated conditions, and demographic trends.
Results: Cotard’s syndrome most commonly occurs in the setting of severe psychiatric disorders, including as severe depression with psychotic features, schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features. It has been known to also occur in dissociative disorders such as depersonalization disorder. Certain neurological conditions that it has been reported in include stroke, brain tumors, epilepsy, right subdural hemorrhage, traumatic brain injury, migraine, insular atrophy, arteriovenous malformations, Laurence-Moon-Bardet-Biedl syndrome, multiple sclerosis, Parkinson’s disease, Hashimoto encephalopathy, anti-N-methyl-d-aspartate receptors encephalitis, and dementias.² Other common neurological comorbidities in Cotard Syndrome include dementia, and encephalitis. The condition is also linked to a high risk of self-neglect and suicidality.³ In a 100-case analysis, common associated symptoms included a central feature of nihilistic delusions about one's own body or existence. Depressive mood, anxiety, delusions of guiltiness, delusions of immortality, and hypochondriac delusions were also present in most cases.⁴ Cotard Syndrome primarily affects middle-aged to older adults (median age 50–52), with rare cases in younger individuals or those with intellectual disability. There is no significant sex predilection, with both males and females equally affected.⁵
Discussion: Cotard’s syndrome represents a rare but clinically significant manifestation of underlying psychiatric or neurological illness. Recognition of its characteristic nihilistic delusions is important for early diagnosis and management given the elevated risk of self-harm and medical neglect in affected individuals as well as being an indicator for underlying severe neuropsychiatric conditions.
Embargo Period
6-3-2026
Included in
Cotard’s Syndrome: A review of clinical features and associated psychiatric and neurological conditions
Philadelphia, PA
Introduction: Cotard’s syndrome is a rare neuropsychiatric condition characterized by nihilistic delusions including beliefs that one is dead, does not exist, has lost internal organs, blood, or body parts. It was first described by Jules Cotard in 1880.The syndrome was associated with melancholic anxiety, delusions of damnation, reduced pain sensitivity, and increased risk of self-harm and suicidality. Although it is not recognized as a formal diagnostic entity in the DSM-5 or ICD-11, Cotard’s syndrome occurs in association with a variety of psychiatric and neurological disorders.¹
Objective: The objective of this presentation is to review the clinical characteristics, associated psychiatric and neurological conditions, and demographic patterns reported in the literature on Cotard’s syndrome.
Methods: A narrative literature review was conducted using peer-reviewed publications describing Cotard’s syndrome. Key articles, including clinical reviews and case analyses, were examined to identify common clinical features, associated conditions, and demographic trends.
Results: Cotard’s syndrome most commonly occurs in the setting of severe psychiatric disorders, including as severe depression with psychotic features, schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features. It has been known to also occur in dissociative disorders such as depersonalization disorder. Certain neurological conditions that it has been reported in include stroke, brain tumors, epilepsy, right subdural hemorrhage, traumatic brain injury, migraine, insular atrophy, arteriovenous malformations, Laurence-Moon-Bardet-Biedl syndrome, multiple sclerosis, Parkinson’s disease, Hashimoto encephalopathy, anti-N-methyl-d-aspartate receptors encephalitis, and dementias.² Other common neurological comorbidities in Cotard Syndrome include dementia, and encephalitis. The condition is also linked to a high risk of self-neglect and suicidality.³ In a 100-case analysis, common associated symptoms included a central feature of nihilistic delusions about one's own body or existence. Depressive mood, anxiety, delusions of guiltiness, delusions of immortality, and hypochondriac delusions were also present in most cases.⁴ Cotard Syndrome primarily affects middle-aged to older adults (median age 50–52), with rare cases in younger individuals or those with intellectual disability. There is no significant sex predilection, with both males and females equally affected.⁵
Discussion: Cotard’s syndrome represents a rare but clinically significant manifestation of underlying psychiatric or neurological illness. Recognition of its characteristic nihilistic delusions is important for early diagnosis and management given the elevated risk of self-harm and medical neglect in affected individuals as well as being an indicator for underlying severe neuropsychiatric conditions.