Published Paper Details:

Background: Cotard's Delusion (CD), a rare neuropsychiatric syndrome, manifests as nihilistic beliefs ranging from denial of body parts to the conviction of being dead. Despite its historical significance, CD remains under-recognized and diagnostically elusive. Objective: To systematically review the clinical features, nosological classifications, and treatment outcomes of Cotard's Delusion using PRISMA methodology, focusing on literature published before January 2019. Materials & Method: A systematic search of PubMed, Scopus, Research gate, academis.edu and PsycINFO was conducted for English-language case reports, series, and reviews on CD published before January 2019. Data were extracted and synthesized into thematic domains. Results: A total of 227 databases were screened and 105 full text articles were assessed and after refining, 15 studies, which met the eligibility criteria were included. CD presents in three phenotypes: Cotard Type I (pure nihilistic delusions), and Cotard Type II (nihilism with depressive features) and Cotard Type III (mixed psychotic-depressive presentations). Neuroimaging consistently implicates right hemisphere and frontoparietal dysfunction. Electroconvulsive therapy (ECT) remains the most effective intervention. Electroconvulsive therapy (ECT) was the most consistently effective intervention. Comorbidities included schizophrenia, major depressive disorder, and neurological disorders. Conclusion: Cotard's Delusion is a multifactorial syndrome with diverse psychopathological substrates. Recognition of its subtypes and tailored interventions may improve prognosis.