Some had a history of preoccupation with their genitals. These are regarded as complete forms of koro, matching all the symptoms required for diagnosis without significant co-morbidity. If male patients insist that their penis is shrinking and disappearing,[5] measurements after intracavernosal alprostadil may be used in the office to determine the true erect length and to diagnose any penile abnormalities in the erect state. Other. Thank you, {{form.email}}, for signing up. Social representations about juju constitute consensual realities that propose both a means and motivation for genital-shrinking experience. Koro or Genital retraction syndrome (GRS), generally considered a culture-specific syndrome, is a condition in which an individual is overcome with the belief that his/her external genitals—or also, in females, breasts—are retracting into the body, shrinking, or in some male cases, may be imminently removed or disappear. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Did You Know That a Phobia of Chewing Gum Actually Exists? "Koro" (genital retraction syndrome): Psychotherapeutic interventions. Koro is a form of mental illness specific to: Southeast Asia. Pain, tingling and other physical symptoms are common in koro but could also indicate an underlying physiological condition. A phobia is a type of anxiety disorder. In many cases, treating the underlying condition also causes the koro symptoms to subside. Fishbain, D., Barsky, S., and Goldberg, M. (January, 1989). [14][35], A koro epidemic struck Singapore in October 1967 for about ten days. What this means is that due to specific cultural norms, behaviors, and dominant views, the experiences and … Many non-western cultures recognise states of mind that look like mental illness but which do not fit the categories of the Diagnostic and Statistical Manual of Mental Disorders (the DSM). It appears to be heavily influenced by cultural beliefs, which might explain why epidemics are common. [10] These forceful attempts often lead to injuries, sometimes death. What appears to be the role of compulsive behavior in an obsessive-compulsive behavior disorder? [10], Extremely anxious sufferers and their family members may resort to physical methods to prevent the believed retraction of the penis. The symptoms subsided when the witches were appeased. Mental illnesses take many forms. During the "Burning Times" of medieval Europe, witches were held responsible for genital retractions in the local population. Mattelaer, J. and Jilek, W. (2007, September). If you're suffering from koro, talk therapy may help you learn new and healthier ways of relating to your body. Still, others had an existing mental health disorder or a history of substance abuse. Ever wonder what your personality type means? Koro Phobia. Cases of this fear have been reported around the world in Asia, Africa, Europe, and the U.S. Some research shows that antipsychotics are sometimes helpful in reducing symptoms. [15], In the ancient Chinese medical book Zhong Zang Jing (simplified Chinese: 中藏经; traditional Chinese: 中藏經), retraction of the penis with distension of the abdomen was described as a certain sign of death. Additionally, the physician should inquire about overall beliefs, personal values, and assumptions that the patient is making about his or her genitals. In addition to the specific symptoms of each mental disorder, children with a psychiatric illness can exhibit signs that are specific to their age and developmental status. Koro is a form of mental illness specific to: Southeast Asia. DSM-IV explains the process of differential diagnosis between these two disorders. These changes may trigger a koro attack when observed, although the effects of cold temperatures are objectively reversible. For example, an outbreak might be blamed on an invading force or an individual rival. A 2008 study in the Journal of German Psychology found that many sufferers reported a recent sexual encounter that made them uncomfortable, such as an extramarital affair. The choice of psychotherapeutic treatment is based on the psychiatric pathology found. [47][48] In most of the non-Chinese cases in the Western hemisphere, genital shrinkage is reported but not all the other typical koro symptoms, such as fear of death, as in endemic countries. Koro is a culture-bound syndrome delusional disorder in which an individual has an overpowering belief that one's sex organs are retracting and will disappear, despite the lack of any true longstanding changes to the genitals. Secondary koro is proposed to have co-morbidity with a CNS disorder, another psychiatric disorder, or possible drug use. [9] According to literature, episodes usually last several hours, though the duration may be as long as two days. Retrieved 25 March 2013, from EBSCOhost. Science. Koro is an irrational perception that one's prominent sexual body parts are withdrawing into the body and subsequently being lost. If a fox spirit is believed to be involved, people may hit gongs or beat the person to drive it out. In a mental health setting, you may find an OT addressing general strengthening, adjusting wheelchairs, recommending adaptive equipment, or any other task that is within the scope of occupational therapy. [53], Most of the ancient literature concerning koro was related to Chinese ethnic groups. [7], For sporadic Western cases, careful diagnostic workup including searching for underlying sexual conflict is common. [10] Koro may also be derived from Malay term Kura which means "head of turtle"[59][14] or keruk which means "to shrink". German Journal of Psychiatry. ; 1998: 2120–43. Prognosis appears to be better in cases with a previously functional personality, a short history and low frequency of attacks, and a relatively uncomplicated sexual life. Females occasionally suffer from a variation of koro in which they believe that their nipples are retracting. Mass Koro epidemic was reported in Labour Camps in Kochi, Kerala in South India during August and September 2010 among migrant labour population from North and North-east India. [1][2] Koro is also known as shrinking penis, and it is listed in the Diagnostic and Statistical Manual of Mental Disorders. Establishing the diagnosis of a mental illness in children usually involves the combination of comprehensive medical, developmental, and mental health assessments. [3] The Malleus Maleficarum, a fifteenth-century European manual for witchcraft investigations, relates stories of men claiming that their genitals had disappeared, being "hidden by the devil … so that they can be neither seen nor felt." [27], Men who present with this complaint may have koro, but they may also be misinformed about normal genital size. [17][10] Differentiation into primary koro, a culture-bound expression, and secondary koro. [59], Genital-related neurosis, in which an individual has an overpowering belief that his or her genitalia are retracting and will disappear, despite the lack of any true longstanding changes to the genitals. The manual gives koro's definition as "a term, probably of Malaysian origin, that refers to an episode of sudden and intense anxiety that the penis (or, in females, the vulva and nipples) will recede into the body and possibly cause death. [49] The incomplete forms of koro are regarded as the non-cultural forms, while the complete form with acute anxiety is the classical culture-bound type. Three separate efforts to define serious mental illness have come to similar conclusions and report similar numbers of people have it. [16], Psychosexual conflicts, personality factors, and cultural beliefs are considered as being of etiological The cases reported amounted to 97 in a single hospital unit within one day, at five days after the original news report. [18], Several criteria are typically used to make a diagnosis of koro. Garlipp, P. "Koro - a Culture-Bound Phenomenon: Intercultural Psychiatric Implications." The Michigan Department of Health and Human Services (MDHHS) - Mental health services for adults who have a mental illness, children and youth who have an emotional disturbance, and persons who have a developmental disability. [4], The condition can be diagnosed through psychological assessment along with physical examination to rule out genuine disorders of the genitalia that could be causing true retraction. This quickly leads to a sudden and pervasive fear that the genitals are disappearing. SING LEE, a psychiatrist and researcher at the Chinese University of Hong Kong, watched the Westernization of a mental illness firsthand. ... not in others suggests that the form mental illness takes can be significantly shaped by a person's environment. Another example of a culture bound mental syndrome is koro in China and areas of Southeast Asia where Chinese culture has diffused (especially Vietnam, Malaysia, and Singapore). Features. [59] The word is also used in Makassarese language, meaning "to shrink"; the full expression is garring koro. For example, in some West African outbreaks, the sufferers believed that, rather than retracting into their bodies, their genitals were being stolen for occult reasons. [26], Various authors have attempted to distinguish between complete and incomplete forms of koro, along with cultural and non-cultural forms. Possession by the Zar is a form of mental illness specific to: Southeast Asia. Social Science. [14], The popularity of Chinese folklore also plays a role. While mental illness can occur at any age, three-fourths of all mental illness begins by age 24. Personal and cultural morals, religious doctrine and current mental health status often play a role in individual cases. Retrieved 5 March 2013, from Ebscohost Database. There was no evidence of significant premorbid or sexual psychopathology in most cases.[55]. Coping WIth Koro or the Fear of Genital Retraction, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. Koro is a culture-bound syndrome delusional disorder in which an individual has an overpowering belief that his or her sex organs are retracting and will disappear, despite the lack of any true longstanding changes to the genitals. Multiple personality disorder is a form of mental illness specific to: Western countries. [19] It has been argued that the criteria are sufficient but not necessary to make a diagnosis of koro. This diagnosis is found in Asia, specifically Southeast Asia. In 1967, there was a koro epidemic in Singapore after newspapers reported cases of koro due to eating pork which came from a pig that had been inoculated against swine fever. [7] Though there are speculations that the occurrence of koro among people in Malaysia and Indonesia was the result of Chinese migrants, this cultural diffusion view is challenged since koro epidemics have been reported in Thailand and India, involving masses of non-Chinese people. Koro—The psychological disappearance of the penis. Read our, Medically reviewed by Daniel B. Females occasionally suffer from a variation of koro in which they believe that their nipples are retracting. [14] The term koro is also known as rok loo (genital shrinkage disease) in Thailand, jinjinnia bemar in Assam, India, and lanuk e laso by Bogoba tribe in Philippines. Attempts have been made to fit Koro into the etic or externally defined psychiatric nosology, including acute hysterical panic reaction, anxiety states, depersonalization, conversion disorder, or atypical somatoform disorder ( Simons & Hughes, 1985 ). The primary criteria is a patient's report of genital (typically penile or female nipple) retraction despite a lack of objective physical evidence demonstrating retraction. Phobia. Antidepressant medications are often prescribed. What's Really Causing Your Fear of Cruise Ships? In:Walsh PC, Retik AB, Walsh PC, Campbell MF, eds. Because it's common for people with this fear to have other conditions, Western mental health professionals often perform a full workup to determine exactly which factors are in play. [7][8], Most patients report acute anxiety attacks due to perceived genital retraction and/or genital shrinkage, despite a lack of any objectively visible biological changes in the genitalia that are longstanding. Given that koro is often an “attack” with a great deal of associated anxiety, the physician should ascertain the patient’s emotional state along with the timeline from onset to the presentation at the examination. [58] Witches were said to store the removed genitals in birds' nests or in boxes, where "they move themselves like living members and eat oats and corn". [33][34], In China, traditional treatment based on the causes suggested by cultural beliefs are administrated to the patient. In the 1970s and early 1980s, newspapers reported incidents of genital shrinking in Western Nigeria. Koro is the fear of the genitals shrinking and retracting into the body. Koro (medicine) Not to be confused with Kuru (disease). [19], In the late Middle Ages in Europe, it was believed that men could lose their penises through magical attacks by witches. [21] A physical examination should note any injuries inflicted by the patient in an effort to "prevent" retraction as further confirmation of koro. In the 1950s, koro is noted in nosological and diagnostic psychiatry. A classic culture-bound syndrome is koro, which is common in Southeast Asia and in China (Cheng, 1996). Types of Mental Illness. ... social anxiety disorder, and specific phobias. You may be able to ski the world's tallest mountains but be unable to go above the 5th floor of an office building. The 1984–1985 epidemics lasted for over a year and affected over 3,000 people in 16 cities and provinces. Some reported high levels of fear, guilt or shame. [17] Sexual adjustment histories of non-Chinese victims are often significant, such as premorbid sex inadequacy, sexual promiscuity, guilt over masturbation, and impotence. Koro is also thought to be transmitted through food. Mental illness, also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. [7] A 1992 study of self-report questionnaires suggests that in the epidemic area of China, koro victims are mostly Han, male, young, single, poorly educated and fearful of supernatural forces and koro. The novel about ghost stories Strange Stories from a Chinese Studio describes a fox spirit which can make people weak physically and sexually and shrink their tissues. Acrophobia is a fear of heights. Anorexia nervosa is a form of mental illness specific to: Western countries; Subjects. [57], Comparing West African genital-shrinking epidemics with koro in Southeast Asia, the latter has symptoms centered on genital retraction (instead of shrinkage) and fear of death (which is absent in African cases). Elder JS. Block, MD, Can COVID-19 Cause Psychosis? In other cases, indigenous treatment might include an exorcism, rest, herbal treatments, or other healing practices. The physician should explore the patient’s concerns about appearance and body image (ruling out body dysmorphic disorder). Improvement in local economic conditions, associated with a better quality of life, is suggested to contribute to the fading of the episodic occurrences of koro. 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