Cotard Delusion

Also called Cotard Syndrome or Walking Corpse Syndrome, Cotard Delusion is a rare neuropsychiatric disorder characterized by the sufferer holding the belief that he or she is dead. More specifically, the sufferer thinks that he or she is decomposed, non-existent, and/or has lost internal organs.

Jules Cotard first described this disorder at a lecture he was giving in Paris in 1880. In this lecture, Cotard referred to the disorder as le délire de negation, or negation delirium. He used a woman to serve as an example that the disorder has varying degrees of severity, ranging from mild to severe. The woman that he described was in denial about the existence of God, the Devil, several parts of her body, and her need to eat. She went on to believe that she was eternally damned and could no longer die a natural death. Ironically, she died of starvation.

Cotard Delusion is prevalent in cases of psychosis such as schizophrenia and bipolar disorder. Depression, however, is always existent in patients with Cotard Delusion. In rare cases, it has resulted from an adverse drug reaction to antiviral medications that are used primarily to treat shingles and genital herpes.

A patient with Cotard Delusion will show behavior identical or similar to isolating him or herself to an area, such as a bed, for extended amounts of time. The victim will most likely begin to neglect personal hygiene, begin to lose vocal inflections and spontaneous facial expressions, and deny emotive differences. The depression is one that does not cause suicidal ideation, due to the victim’s belief that he or she is already dead.

Cotard Delusion is similar to Capgras’ Delusion as they are both thought to result from a disconnect between the areas of the brain that recognize faces, and the area that responds emotionally to a recognized face.

Cotard Delusion is prevalent in cases of psychosis, such as depression, schizophrenia, and bipolar disorder. It has also resulted as the result of an adverse drug reaction to antiviral medications that are used primarily to treat shingles and genital herpes.

Treatment for Cotard Delusion is difficult and very limited; there has been only one therapy that has shown promise: electroconvulsive therapy, or ECT. ECT is a therapy in which seizures are electrically induced onto medically desensitized patients for therapeutic effect. Along with ECT comes the risk of severe memory loss and responsibility. If ECT is not followed by drugs or further ECT, or the benefits will be lost. Also, the treatment cannot be administered without an informed consent by the patient that states the risks, benefits, and reason for treatment.

Following ECT, the medication that the patient is prescribed to maintain benefits gained is very important. Generally, the patient is given Olanzapine, a drug used to treat conditions such as anxiety and eating disorders, and Escitalopram, used to treat anxiety and depression. There have been other cases involving different drugs that share the same general principal. 

Foreign Accent Syndrome

Foreign Accent Syndrome is a rare and acquired condition involving speech production. Sufferers of this condition do not acquire new knowledge of a foreign language, but rather unanticipatedly start to pronounce his or her native language with the accent from another known or unknown language.

Foreign Accent Syndrome, or FAS, is adopted as a result of a severe brain injury. Common culprits of a traumatic brain injury followed by FAS are stroke, trauma caused by sharp impact, multiple sclerosis, brain hemorrhages, and related circumstances.  

Researchers at Oxford University have found that this disorder is caused by specific parts of the brain being injured. This knowledge leads to the realization that certain parts of the brain, namely the cerebellum, control various linguistic functions. If damage is done to these brain parts, the result could be altered pitch, mispronounced syllables, and other specific speech patterns being distorted in a non-specific manner.

Symptoms of Foreign Accent Syndrome pertain to style, presentation, and pronunciation of language. Some symptoms include making vowel sounds unnecessarily shorter and longer (changing English “yeah” to German “jah”); moving jaw differently while speaking,  resulting in changed sound quality of words; mispronunciation of syllables; and altered pitch of speech. Symptoms could last for months or years.

When a person is diagnosed with Foreign Accent Syndrome, there is one primary treatment option that he or she can undergo: speech therapy. Skills such as moving the lips and jaw differently while speaking are attended to and mastered by both therapist and patient. Developing these techniques may help to alleviate, if not solve, the problem.

To supplement speech therapy, counseling may be an option for the patient. While this will not cure the condition, it may help the victim and his or her family to better cope. This is important because of FAS’ rarity, resulting in a high likelihood for feelings of isolation and embarrassment to be present.

Capgras' Delusion

Also called Capgras Syndrome, this disorder is characterized by the delusion that a close family member is impostor that looks exactly like him or her. Delusions can occur in an acute, transient, or chronic form.

Most frequently Capgras Delusion is prevalent in patients with schizophrenia, but has also been found in people with conditions such as dementia or a brain injury. It is most common in females, with a female:male ratio of 3:2.

A 1984 study by R.M. Bauer revealed that, even though face recognition was impaired, the patients with this disorder showed activity in the peripheral nervous system, controlling involuntary responses such as perspiration, salivation, sexual arousal, and similar responses.

In 1997 Hadyn Ellis and his colleagues administered a study using five people with Capgras Delusion and schizophrenia. The people in the study could consciously recognize faces, but did not show normal autonomic emotional arousal response. Abnormal autonomic emotional responses are related to Crapgras patients recognizing faces, but remaining emotionally detached as a result of believing that said person is an impostor.

Vilayanur Ramachandran, a behavioral neurologist, hypothesizes that the origin of this condition is a disconnection between the temporal cortex, the part of the brain used to recognize faces, and the limbic system, the part of the brain that produces emotion.


Although no definitive impairment has been linked to this disorder, researchers have concluded that victims have an impairment in reasoning. There is no known treatment for this condition.