Hello, hello, I'm Kenna. I'm Koelle and welcome back to diagnosing a killer
mental breakdown
There you go. There you have it ladies and gents. We are back with the other...
ladies and joins. I hate that. Goils and joins. The girly girls. Shout out Haley and Anai and Kaelin.
Even though they don't listen, it's okay. It's okay. Nobody ever listens. We are back with
another mental breakdown. I actually did something different for this one, so I'm really excited
about it. No celebrities, no killers. I am going all the way in with the diagnoses. Okay. I'm just
going to get right into it because this is going to be a longer than usual mental breakdown. Okay.
So I decided to research the top 10 rarest mental disorders. I had only heard of like three of these.
Really? I swear. Okay. Okay. I'm going to kind of spurt these off. So number one, it's not in any
particular order. So the first one that I'm going to talk about is called Kill Cap Syndrome and it's
spelled K-H-Y-A-L. It's Cambodian. It's like where it's most prevalent. So Kill Cap, or better
known as Wind Attacks, is a syndrome found among Cambodians in the United States and Cambodia.
According to the DSM-5, common symptoms are similar of those apanic attacks. These include dizziness,
palpitations, shortness of breath, and cold extremities along with the symptoms of anxiety
and anatomic arousal such as tinnitus and nexornus. Why is it only in Cambodians? Well, you'll see.
Not only, but most often found in Cambodians. Now these attacks are centered on kill, which is a
wind-like substance. This is like a phenomenon. So it's rising in the body and the blood and it
causes a range of serious effects. So like, you know when you get the wind knocked out of you?
It's kind of like getting the wind knocked into you, right? No, it's a little bit different.
They may occur without warning and the attacks usually meet the criteria for panic attacks.
There's actually a study done in culture medicine and psychiatry that found that Cambodian refugees
with PTSD often complain of these attacks. It involves a great fear that death might occur
from bodily dysfunction. So a headache from panic attacks, shortness of breath, you think that you
will die from those symptoms. Kill cap is an example of a cultural syndrome or a syndrome that tends
to co-occur among individuals in specific cultural groups, communities, or contexts that explains why
it's mostly prevalent in one area. During the Pol Pot Regimen, that was from 1975 to 1979,
one to three million of Cambodia's population of seven million died of starvation, illness, or
execution. It was very tragic. Major traumas, of course, followed, including slave labor,
slave labor, starvation, disease, physical displacement, lack of shelter, physical and
sexual violence, and the torture and killing of friends and relatives. They were pretty much
an inconsistent threat of death, like everybody, by illness, starvation, or execution. Okay, so at
the end of the Pol Pot, like I said in 1979, Vietnamese troops invaded the country, leaving
civilians to be trapped. There was, of course, a lot of fighting going on, and they were exposed
to artillery and small arms fire. But even after managing to escape from Cambodia, as many were
able to do during this chaos, refugees still had to endure the additional hardship of long stays
in dangerous refugee camps, of course. So it's like a combination between panic attacks and almost
PTSD. Yeah, and maybe acute stress as well. So all in all, my point to this being that the
factors that occurred here determined the levels of the disorder that would eventually develop
and would be expected from the extraordinary levels of trauma, of course. So Cambodian refugees
have high rates of psychopathology. There was a large survey that I looked up. They did research
on it. It was a total of 586 Cambodian refugees in Long Beach, California, found that 62% of them
had PTSD and 51% had major depression disorder. Wow. Among Cambodian refugees treated at
psychiatric clinic in the Boston area. Another study found that 56% had PTSD with elevated
PTSD scores on PTSD scale and another 60% rate of panic disorder, which they culturally refer to
as kill cap. Yeah. So that's the first one. Wow. And I say, I say rarest mental disorders,
but I'm over here 56%. Yeah. That's a lot. Of an entire culture of people. Yeah. So the second
cultural syndrome that I want to talk about is called Cufangisia, or it's also referred to as
thinking too much. Oh, okay. It's found among the Shona people of Zimbabwe mostly. And many cultures
thinking too much is considered to be damaging to the mind and body, which causes specific symptoms
like headaches and dizziness. I mean, that's really interesting. Even in our culture,
thinking too much, stressing too much, it can be really damaging to your health.
It elevates your blood pressure and all that stuff. Yeah. So Cufang...
I have had such a hard time saying this word. We probably laughed about it for like five whole
minutes just now and then I messed up again. Cufangisia involves ruminating on upsetting
thoughts, particularly worries. And as a cultural expression, it's considered to be causative to
anxiety, depression, and some problematic symptoms. So example, my heart is painful because I think
too much. That's how they would interpret that in Zimbabwe. Thinking too much is a common idiom of
distress and cultural explanation across many countries and ethnic groups, including Africa,
the Caribbean, Latin America, and among East Asian and Native American groups. The term cultural
concept of distress is a new addition to the DSM-5. Cultural concepts of distress refers to
ways that cultural groups experience, understand, and communicate suffering, behavioral problems,
or troubling thoughts and emotions. The term is a recent advance in the history of attempts to
categorize psychological distress with demonstrable cultural influence that lacks one-to-one unity
with biomedical psychiatric diagnoses. That's like a mouthful, but pretty much it's like
similarities in all of these syndromes, disorders, and stuff across different cultures, but we name
them different things. So they kind of have their own interpretation of it. I was going to say when
you were listing off those countries like Africa, Latin America, the Caribbean, I feel like that's
so many people. Clearly that's a very real diagnosis when you think. Yeah, definitely.
Well yeah, so they kind of put all of those different cultural ones under that umbrella
of cultural concepts of distress in the DSM. I see. I feel kind of weird about that. It's a little
like, oh that's your interpretation of what that is. Yeah, it's a little off thing. But it is.
Again, this is number two on the most rarest disorders or symptoms.
Or yeah, it's just rare, the sort of the general, not the top two. No, I know, but I mean like what
I'm saying, that's like millions of people. Yeah, and I think that's maybe what we're not listening
about this. This one specifically rare quote unquote is because it's... Cufangisia. Cufangisia
is specifically in Zimbabwe. I think that's why it's rare. Oh, because of the word itself. I see,
okay. Yeah, I don't think it's the whole concept. Yeah. It's called CCD, the cultural concept of
distress. So the attempt to label CCD dates back to Pao Min Yeop's research in Hong Kong in the 1950s
and 60s. He employed the term culture-bound depersonalization syndrome to describe Koro,
which in their culture is a state of acute anxiety with partial depersonalization associated with
fear of the penis retracting into the body. So this is under that same umbrella, but just in a
different cultural... I see, okay. But it's cultural concepts of disorders. Yes, the term cultural bound
syndrome has been used in cross-cultural psychiatry since and was included in the DSM for. So number
three is called clinical lycanthropy. So clinical lycanthropy involves a delusion that the affected
person can transform into an animal. It's often associated with turning into a wolf or werewolf.
Oh, like other ken. Yes. I think that's so cool. The name of the syndrome originates from the
mythical condition of lycanthropy or shape-shifting into wolves. People with this disorder believe
that they can take the form of any particular animal and during this delusion or hallucination,
affected individuals can act like the animal. For instance, people may act like wolves and be
found in forest and wooded areas. The Journal of Neuropsychiatry and Clinical Neurosciences labels
this disorder as a type of delusional misidentification syndrome. Since 1850, there have been 56
original cases descriptions of people who believe they were metamorphosing into an animal. Since 1850,
it's been almost 200 years and there's only been 56 cases. Among these 56, only 13 met the criteria
for clinical lycanthropy, which is again the medical term for having delusions. The objective
clinical is used to emphasize that the condition does not mean actual lycanthropy or the ability
to metamorphose physically, of course. But only 13 out of those 56 have been actually diagnosed and
said this is a you or you have clinical lycanthropy. And 56, I guess, are the descriptions of people.
Yeah, reported cases. Okay. Okay. But reported is not diagnosed. You're saying 13 of them have been
diagnosed. I think that's really interesting. Yeah. There is such thing as called other kin and
other kin is basically that. Yeah. It's like a, I guess like a layman's term for the, for the actual
term. Yes. Would be other kin. Yes. So number four, you might remember you being Quelle and you being
the listeners might remember from the Josh Phillips case. It is depersonalization, derealization
disorder. And I did briefly speculate that Josh Phillips may have been suffering from this
disorder at the time that he killed Maddie Clifton. I don't know if that's true or not,
but that's just something that could have been a possibility. So depersonalization,
derealization disorder is described as the separation from oneself, one surroundings,
or both patients who have this disorder feel as though they are observing themselves from
outside their own body. They may also believe that things aren't real as though their surroundings
are distorted or time is speeding up or slowing down. One or both of these tendencies can lead to
DDD. I'm just going to call it that because it's a long title. Symptoms must be persistent to qualify
for a diagnosis because according to psychology today, it's normal to feel this way briefly due
to side effects of medication, recreational drugs, or some other physical or mental health condition.
So it has to be persistent and ongoing. So something similar, but not the exact same called
transient depersonalization, derealization is actually quite common. This situation occurs
when you experience depersonalization from symptoms very briefly. So you have a fleeting
feeling of being detached from yourself or the environment. You may feel like you're watching
yourself in a movie. Like if you're at a really early meeting and you're just zoning out a little bit.
Experts estimate it occurs in about half of the population, just the transient part of it.
Is that also when you drive home and you forget you even drove there?
Yeah, and you're like, was that light green or did I just go through a red light?
So reoccurring DDD occurs in less than 2% of the population and it's very rare for
depersonalization, derealization to actually need treatment, which I thought was interesting.
So like your brain can typically snap you out of it at some point?
Yeah, or maybe talk therapy or something. But I think treatment as in like recurring, you know.
Now coming in at number five, we have Diogenes syndrome.
Diogenes?
Diogenes.
Okay.
The compulsive hoarding of rubbish and seemingly random items is the main feature of this syndrome.
Okay.
It's found mainly in the elderly and is associated with progressive dementia as well.
Other characteristics include extreme self-neglect, apathy, social withdrawal, and a lack of shame.
So it's pretty much like an extreme hoarder of trash.
Where it's like, yeah, where you watch episodes of hoarders and there's like excrement all over
the bathroom and stuff like that.
Exactly. Or there's like literal garbage or just like newspapers that you don't need things like that.
I find that stuff really interesting honestly because like I don't think I'm the neatest person,
but I certainly don't keep like food stuff in my room.
Like usually just the occasional like empty water bottles.
And I say water bottles.
The occasional water bottles.
But yeah, hardly ever food.
But I do, you know, I think everybody's seen network television, national network television.
I won't say the network's.
Everyone's seen an excerpt of something similar to one.
Yeah, of course.
It's on TV and I think, I mean, it's like the one thing that doesn't jump out is the smell.
You know, you can't smell it, but you can see it.
And you're like, how are people blind to that?
Yeah.
I don't think it's not blindness.
But you get used to it.
Yeah, exactly.
Now this syndrome is a misnomer as it is named after the Greek philosopher Diogenes of Sinep.
Diogenes was a cynic who, according to the philosophy he helped found, rejected the desire
for wealth, power and fame, choosing to live free from all possessions.
He found virtue and poverty slept in a large ceramic jar and sought social interaction.
Wow.
I feel like that's like the ultimate camper life.
What is that like?
Hashtag van life.
It's like, yeah, hashtag vase life.
Hashtag ceramic jar life.
So the annual incidence of this syndrome has been estimated to be around five per 10,000
individuals age six year older and living alone.
Those are the most common.
There's been mixed evidence in terms of prevalence in comorbid disorders.
A study of 30 individuals with this syndrome found that 50% had no comorbid psychiatric
disorder.
Another study included 72 individuals with this syndrome found that isolation, alcoholism,
and psychotic disorder coexisted.
Although these two studies have the largest sample sizes studied for the disorder,
a major limitation of the studies is that they were both published before 1975,
bringing of course into question validity and reliability.
Well, I mean, yeah, when was the last time they studied that?
That's just this specific study that I looked at.
But over the years, several individual reports have been published highlighting the continued
identification of the syndrome.
So it is still happening.
It didn't just stop because these articles and apps, these articles didn't have an update.
Number six is Stendhal syndrome.
So those with Stendhal syndrome experience physical and emotional anxiety as well as panic
attacks to sociative experiences, confusion, and hallucinations when exposed to art.
What?
It's very unheard of.
And it's really unheard of.
Yeah.
These symptoms are usually triggered by quote,
art that is perceived as particularly beautiful or when the individual is exposed to large
quantities of art that are concentrated in a single place such as a museum or gallery.
However, individuals may experience similar reactions to beauty in nature.
The syndrome is named after a 19th century French author who experienced symptoms during
a trip to Florence in 1817.
Stendhal syndrome may also be called hyperculture mania or Florence syndrome.
There wasn't a lot of information about prevalence, but I did find that in 1989,
an Italian psychiatrist and the Santa Maria Nuova Hospital in Florence
wrote up observations on the 106 visitors who had been treated as emergencies and even
hospitalized in her department in the previous decade.
Most of them had been transported straight to the hospital from the city's art galleries
and museums.
Their symptoms including dizzy spells, palpitations, hallucinations,
disorientation, loss of identity, and physical exhaustion.
Precipitating factors, things that also could have made this happen,
were an impressionable personality, the stress of travel, and the encounter with a city like
Florence because it's known for being haunted by ghosts of the great death in the perspective of
history.
Well, it's also massive.
Yeah.
And it's also gorgeous.
And it's overwhelming, I feel like.
Yeah, I wonder if people are just going to faint when they go to Florence.
So again, this was in 1989 and the treatment was just getting out of Italy as soon as possible.
So there's no really known cause.
Yeah.
Or you know treatment.
Number seven.
So this is getting out of Italy.
Everybody's like just leaving.
I feel like they made that up just to get rid of tourists.
Right.
Number seven is called a Podium nophelia, also known as body integrity identity disorder.
A Podium nophelia is characterized by the overwhelming desire to amputate healthy parts of the body.
Oh my God, that's awful.
Though not much is known about it, this disorder is believed to be neurological.
Those affected may amputate or attempt to amputate their own limbs or damage the limbs so that
surgical amputation is necessary.
That's so scary.
A Podium nophelia may be related to damage to the right lobe in the brain.
The condition is challenging to treat because people experiencing it often do not seek treatment.
Yeah.
However, both cognitive behavioral therapy and aversion therapies can be attempted in order
to treat it once treatment is sought.
So the incidence of this disorder is estimated to be several thousand people worldwide.
This is partially based on the number of affected participants in relevant internet forums that
people confide in, but it's not a set number.
Is it not a part of what would be considered a self-harm thing?
I don't think so.
It's incredible.
It says it's assumed to be neurological.
Yeah.
Fewer people are affected by the desire to be blind.
Official estimations of its frequency are not currently available, but this part of a similar
disorder is that people want to be blind so they induce blindness on themselves.
Okay, so Andre Thomas pulled out his own eyes.
Is that something that he suffered from?
Hear what I'm going to say next.
The exclusion criteria for this includes psychotic disorders such as schizophrenia or
delusional disorders.
So if you are diagnosed with schizophrenia, you cannot in turn be diagnosed with this.
Yeah, it would be a main contributor for actions like that instead of this.
Number eight I have for you is called Alien Hand Syndrome.
Alien Hand.
This syndrome is characterized by the belief that one's hand has its own life and doesn't
belong to itself.
Individuals experiencing Alien Hand Syndrome have normal sensation,
but feel that their hand is autonomous.
Those with Alien Hand Syndrome may personify the limb as a separate entity.
The unaffected hand is under the individual's control while the affected hand has its own
agenda.
It's like idle hands.
Do you ever see idle hands?
No.
Idle hands?
No, from a 90s movie with Devonsawa.
I think it's one of Jessica Alba's first movies ever.
And again, it's in the 90s.
And it's like Bay Devonsawa and Bay's Seth Green.
Sorry, sorry, buddy.
I love Seth Green.
But yeah, he's in it and then, but it's about Devonsawa's hand is like possessed by a devil
and it kills people.
That's exactly what that sounds like.
Yeah.
So this syndrome is thought to occur in individuals who have damage to the corpus callusum,
which connects the two cerebral hemispheres of the brain.
Other causes include stroke and damage to the parietal lobe.
The hands then appear to be in an intermanual conflict or meaning they act in opposition
to one another.
Wow.
A remarkable form of hemian attention occurs in the alien hand syndrome.
In this disorder, a patient's left hand retains at least rudimentary motor and sensory functions,
but the patient cannot control its movements or appreciate its sensations.
Without the patient awareness, the hand moves semi-purposefully independently making
autonomous explorations and performing simple tasks such as scratching or moving like moving
clothes around on the body.
In an often quoted example, a patient reported that her hand intermittently attempted to choke her.
Patients may treat the hand as though it were an errant child, sometimes rebunking, slapping,
or chastising it.
The alien hand syndrome definition technically requires that the patient reveals two misperceptions.
One, the patient does not possess the hand and two, because the hand's movement takes place
without the patient's knowledge and control, another person, aka the alien, governs it.
Most patients simply feel estranged from the hand or only accept a tenuous relationship with it.
Non-dominant lobe injury underlies most cases, but some have occurred in the context of corpus
callosome injury.
Alien hand syndrome is present in approximately 60% of affected individuals.
That's incredible.
What an incredible syndrome.
It's very different than what we're used to seeing when we talk about mental disorders.
So number nine is called capgrass syndrome.
This syndrome is named for Joseph Capgrass, a French psychiatrist who explored the illusion
of doubles.
This one I was blown away with reading about.
Those with capgrass syndrome hold the delusion of belief that someone in their life,
usually a spouse, close friend, or family member, has been replaced by an imposter.
Yes.
It can occur in patients with schizophrenia, dementia, or epilepsy and after a traumatic
brain injury.
Treatment approaches mirror those utilized for the underlying disorders and can often
include antipsychotic medications, the retrospective evaluation of patient files,
and 920 cases admitted to the psychiatric inpatient unit on this article that I read.
Over five years revealed that 12 patients fulfilled the criteria for capgrass syndrome.
The crude prevalence of capgrass syndrome in this population during the five-year period
was 1.3%.
Schizophrenia, with being 50%, was the most common psychiatric diagnosis in these patients,
and only two patients presented with an organic etiology underlying capgrass syndrome.
So only two patients had this with no other underlying epilepsy.
Really?
Yeah.
I think I've heard of that in certain cases where people have shot people that they know.
Yeah.
Especially like, I remember one case, I'm pretty sure I'm not mistaken about this,
because there was an elderly guy who had been diagnosed schizophrenic and he ended up shooting,
I think it was his son, because he thought he was an imposter.
It sounds like dementia or Alzheimer's.
It's scary.
The tenth and final one that I have for you today is called Alice in Wonderland Syndrome.
It's also known as Todd syndrome, but Alice in Wonderland Syndrome is a neurological condition
in which one's perception of their body image, time, or space is distorted, just like the movie.
Interesting.
Those experiences syndrome may have hallucinations, sensory distortion, and an altered sense of velocity.
Though there are many symptoms, the most prevalent one is altered body image.
Patients are confused about the size and shape and parts of their bodies,
which Alice in Wonderland when she eats the...
The mushrooms.
The mushrooms, she gets bigger or smaller.
These symptoms can trigger panic and fear responses, of course.
Alice in Wonderland Syndrome is often associated with frequent migraines,
brain tumors, or drug use, and can affect children between the ages of five and 10.
It's actually relatively common in children.
Wow.
Alice in Wonderland Syndrome has no proven effective treatment,
but treatment programs for the probable causes of the condition are employed to bring about relief.
So that's all I have.
That was a lot of disorders really quickly, but I just thought it was super interesting to do the
rarest ones because you don't hear about those, especially in cases with criminal activity.
You don't really hear about those ones because these other symptoms that usually outshine or outweigh
those other ones.
It was really interesting, like the cultural aspect when you talked about the people of Cambodia
or the Khufang Yixia.
Yeah, that was in Bobway.
Yeah, that was really interesting.
I don't know.
Like I feel a little weird about the fact that it's under a cultural blanket.
We all mean the same thing, right?
But just because it's not in the DSM-5, we call it something else.
And I guess it's just like maybe an American thing.
But yeah, I think it's really interesting, like cultural, like the thought of thinking too much.
Yeah.
The thought of thinking too much is detrimental to you and how, you know, and again, like we talked
about it relating to anxiety disorders or stress disorders.
It's really interesting for those people.
It really does kind of shed light on, you know, like you said, the different cultural aspects.
I feel like I learned a lot, but it also shows how similar we are to people on the other side
of the world.
You know, we might believe different things when it comes down to it, but things like that
resonate with each other and they're really similar.
I just think that's super interesting.
Mm-hmm.
If you guys have any out there disorders that you want us to talk about that are rare or, you
know, not only talked about very often or not really heard of, please let us know.
We will talk about it for sure.
Thanks for being the topic.
That was really cool.
Yeah.
It's something different.
I popped into my head last night and I was like, oh my god, I have to do this.
Yeah.
Like I started researching and I was like, I have to.
And, you know, there's many more than just those 10.
I just wanted to make it not a three hour episode.
Yeah.
But anyways, yeah, thanks for it.
Thanks for coming.
Awesome.
Like you have a choice.
Thanks for being here.
Thanks for listening.
You guys can follow us on Instagram at Diagnosing a Killer.
We also have Twitter at Killer Diagnosis,
diagnosing a killer at gmail.com, patreon.com slash diagnosing a killer.
And if you didn't, he listened to our last episode.
We were on Great Day S.A.
You can find that by googling Great Day S.A.
That is S.A. as in San Antonio 1217, 2021.
And our article, okay.
Love you guys.
Love you.
Bye.
So number two coming in at number two.
Number two.
It is called...
Good luck.
Coo-fung-giz-ee-ah.
I said this.
Giz-ee-ah.
I think it's giz-ee-ah.
Giz-ee-ah.
I'd put it in there phonetically, but I think it's...
Giz-ee-ah.
I don't say giz-ee-ah.
Giz-ee-ah.
Okay, no.
It's full scale giz-ee-ah.
Is that what you said?
Coo-fung-giz-ee-ah.
Okay.
Coo-fung-giz-ee-ah.
I'm gonna say giz-ee-ah.
So, coming in at number two, we have...
Well, I said coming in at number two like it's an order.
I said no for two...
Coming in at number two, it's giz.
I didn't...
I'm gonna come in.
I was like, coming in.
The second disorder...
The second center I'm going to stop it.
Coming in at number two like it's the hot 100.
Number two for this week.
So for this week.
On Kung Fu Giz-ee-ah.
Kung Fu Giz-ee-ah.
It's not Kung Fu, it's Coo-fung-giz-ee-ah.
Kung Fu Giz-ee-ah.
Coming in at number two, it's Kung Fu Giz-ee-ah.
So it's called...
All the...
Giz.
I think it's giz-ee-ah.
Actually, yeah, that's what it is.
Probably giz-ee-ah.
No, it's Kung...
Coo-fung-giz-ee-ah.
That's what it is.
Coo-fung-giz-ee-ah.
Okay.
Like fungi.
Yes, fungi.
Okay, Coo-fung-giz-ee-ah.
Okay.
God damn it.
Okay.
Drink some alwido.
Okay.
Ready?
Ready.
So the second syndrome I'm going to talk about today is called...
Coo-fung-giz-ee-ah.
Coo-fung...
Coo-fung-giz-ee-ah.
Okay.
Coo-fung...
So the second syndrome that I want to talk about is called Coo-fung...
F-fuck-in-a.
How is it spelled?
No, I looked up how to pronounce it.
I looked up this pronunciation.
I put it phonetically.
I know that I'm saying it right.
I just can't say it.
So the second syndrome that I want to talk about is called Coo-fung-giz-ee-ah.
I was so confident.
Like I got this.
I got this.
Shit.
Coo-fung-giz-ee-ah.
I'll just take this one out.
Can we just take this?
We're only out of her two.
Okay.
How many other funny words do you have on there?
Like this is the hardest one to pronounce.
Okay.
I'm gonna remember it later and just reply.
So the second cultural syndrome that I want to talk about is called Coo-fung-giz-ee-ah.
Okay.
You did it.
I did it right.
Yeah.