Kandinsky-Clerambault's Syndrome: Concept of Use for Western Psychiatry

Article excerpt

Abstract: The aim of our paper is to describe Kandinsky-Clerambault's Syndrome, which has important cultural-historical value in the history of psychiatry, and to illustrate the syndrome by means of a case report. Although its component symptoms are known among Western psychiatrists, the syndrome's specific name is generally unknown. The authors suggest that detailed clinical descriptions of some specific conditions may contribute to a more detailed knowledge of psychopathology, a more colorful and memorable view of conditions, with an increased awareness of the historical and cultural origins of psychiatry.

Introduction

In modem psychiatry, there are terms that are historically connected with famous psychiatrists who described specific states, reflecting peculiar psychiatric conditions. The names of these syndromes (Cotard's, Kahlbaum's, Korsakoff's, Capgras' and so on) continue to be widely used by psychiatrists, especially in professional parlance and journals, though they are not included in modern psychiatric classifications. Among them is "Kandinsky-Clerambault's Syndrome" (KCS), which is sometimes misdiagnosed as "Clerambault's Syndrome" or "Erotomanic Delusion" (1, 2). KCS is less known and is used mainly by French, German and Russian psychiatrists, while Clerambault's Syndrome is well-known in psychiatry.

Historical Background

Russian psychiatrist Victor Khrisanfovich Kandinsky (1849-1889), an uncle of the famous artist Wassily Kandinsky, was born in Siberia into a family of successful businessmen. He served as a military physician in the Balkan Russian-Turkish war in 1877 and from that time onward, he suffered from mood fluctuations (3). Kandinsky's first research on hallucinations was based upon detailed descriptions of his own hallucinatory experiences (4). He also reported that while his physician diagnosed him as having Melancholia, his own diagnosis was Primare Verrucktheit, which Berrios (4) anachronistically translated as "Schizophrenia like State." Kandinsky's classical book on pseudohallucinations in German was published in 1885, after he moved from Moscow to St. Petersburg. It should be noted that during his life, Kandinsky published 20 professional articles in Russian, three articles in German and one in French, rendering his work relatively inaccessible to English-speaking professionals. At age of 40 in 1889, Kandinsky committed suicide by morphine overdose. At that time, he was a patient in St. Nicolas Hospital in St. Petersburg, though earlier he had been the hospital's superintendent (3). In a monograph posthumously published in Russian by his widow in 1890, he described a syndrome of mental automatism (as mentioned, a great part of which was actually based upon his self-observation), involving alienation from or loss of one's own mental processes (thought, sensory and motor), which are attributed as belonging to somebody else, combined with delusions of mental or physical influence such as stealing or insertion of thoughts (5).

Gaetan Gatian de Clerambault (1872-1934) was born at la Bourges, not far from Paris. After finishing high school in 1888, he studied at the School for Decorative Art. After that, at his father's request, and in accordance with family tradition, he studied law, and only after graduation de Clerambault began to study medicine. From 1898, he worked as an internist. His doctorate was dedicated to pilot health after aircraft accidents (6, 7). From 1905 until his death in 1934, de Clerambault worked in different fields of medicine. He was a well-educated, successful figure not only in medicine but also in art - many of his paintings are in museums now, as are his clothes models with Oriental motifs. His encyclopedic knowledge included five languages, including Arabic. When a cataract operation was unsuccessful, he became depressed with melancholic features and delusions of guilt, and in November 1934, he committed suicide by firearms (6, 7). In 1942, Jean Frete published two volumes of de Clerambault's works under the name "Oeuvre psychiatrique" (8). …