How we cite our quotes: All quotations are from Vertigo.
Quote #4
ELSTER: There was no way for them to understand. But you and I both know who killed Madeleine.
Elster's reference to Carlotta is meant to displace Scottie's guilt. It's no help. Elster's the guiltiest one in the bunch, but he seems completely untroubled. Diagnosis: sociopath.
Quote #5
PSYCHIATRIST: He is suffering from acute melancholia, together with a guilt complex.
There you have it from the expert: the "guilt complex" is Scottie's official diagnosis. Guilt, coupled with the loss of his love, has undone him.