A psychotic state characterized by anxious depression, suicidal tendencies, and nihilistic delusions in which the patient denies the existence of his body and in some cases believes the whole of reality has ceased to exist.First reported by the French neurologist Jules Cotard in 1880 under the title Delire de Negation, this disorder is now recognized as a separate entity only in France and Italy, and even in those countries it is often considered a symptom rather than a syndrome. It is rarely observed in the United States and would probably be classified as an involutional psychotic reaction of the paranoid type. Arieti and Meth (1959) describe it as follows: “After an interval of anxiety, the patient, generally a woman in the involutional age, but at times even men and younger or older women, denies any existence to the surrounding reality. Nothing exists; the world has disappeared. After the cosmic reality is denied, the physical reality of the patient himself is denied. At first the patient claims that he has lost all sensation throughout his body; in some cases, he later claims that he does not exist. Everything is denied in this overwhelming delusional state. At times even the possibility of death is denied—the patient considers himself immortal. Other symptoms resemble the picture of involutional psychosis: the patient is depressed, may refuse food, has ideas of having been condemned by God. He may also hallucinate. He retains, however, the capacity to talk freely in spite of the depression and often is given to philosophical contemplation about his own life, life in general, and the world.” See NIHILISM,DELUSION, DENIAL OF REALITY.