Brote de histeria epidémica entre estudiantes de secundaria en San Juancito Francisco Morazán, Honduras / Outbreak of epidemic hysteria among middle school students in San Juancito, Francisco Morazán, Honduras

Objetivos: Describir un brote de enfermedad psicogénica en masa entre estudiantes de secundaria, determinar los factores de riesgo y las medidas de control. MATERIAL Y MÉTODOS. Se llevo a cabo un estudio de casos y controles. Se realizaron análisis químicos y bacteriológicos del agua, suelo, productos agrícolas e ingredientes de los alimentos consumidos el día del brote. Se efectuaron determinaciones de colinesterasa sérica entre los casos agudo se inspecciones ambientales del área. RESULTADOS. 89 sujetos fueron entrevistados durante la investigación. La tasa de ataque fue de 48,3%(43 casos). Una tercera parte de los afectados percibieron un olor desagradable que fue el factor desencadenante del brote(OR = 26,67; IC95%: 3,31 a 579,25). En el cuadro clínico predominó: la cefalea (86,0%), dolor epigástrico(76,7%) y mareos (74,4%). Nueve pacientes fueron hospitalizados y la evolución fue satisfactoria. Los estudios bacteriológicos y químicos realizados fueron negativos. Las determinaciones de colinesterasa sérica y las inspecciones ambientales fueron también negativas. DISCUSIÓN. Los hallazgos clínicos, epidemiológicos y laboratoriales fueron consistentes con el diagnóstico de enfermedad psicogénica en masa. CONCLUSIÓN. El reconocimiento temprano de esta entidad clínica y los factores precipitantes permitió la toma de decisiones acertadas en el manejo y control de este problema...

Hysteria: a symptom or a syndrome

A descriptive follow up study of 100 consecutive cases of hysterical [dissociative/ conversion] disorders was conducted from 1995-1998 at CMH Kharian to describe find out the relative frequency of hysterical disorders and other underlying conditions in the patients presenting with hysterical symptoms and also to see the long term validity of this diagnosis. The findings of this work indicated that in 40% of the cases there was either a physical or psychiatric underlying cause of these symptoms i.e. depression [40%], anxiety state [15%], adjustment disorder [17.5%], personality disorder [5%] and medical illnesses [25%]. In 60% of the cases of hysterical disorder who responded to the follow up questionnaire, the diagnosis of hysterical disorder was sustained. The prevalence of hysterical disorder was more in women, among young, undereducated and lower socio-economic groups. In majority of the patients, a psychosocial stress was identified. Convulsions, sensory loss, visual symptoms, aphonia, headache, amnesia and possession state dominated the presenting complaints. Further sound methodological studies using the structured instruments are needed to replicate these findings

Is hysteria still prevailing? A retrospective study of sociodemographic and clinical characteristics.

A retrospective study was conducted in a psychiatric setup of S.P. Medical College, Bikaner (Raj.) to assess the social demographic and clinical characteristics of hysterical patients. The illness was more common in female patients. Most of the patients were young, married and illiterate. Nearly half of them had faced some stress prior to onset of their illness. Fits of unconsciousness and aphonia were the commonest presentation in female and male patients respectively. Duration of stay was 2-3 days and most of the patient responded well to different treatment modalities.

Analysis of psychiatric morbidity of outpatient children in Mitford Hospital, Dhaka.

The objective of this study was to describe the pattern of psychiatric morbidity among 97 child patients who, for the first time attended the psychiatric outpatient department of Sir Salimullah Medical College & Mitford Hospital, Dhaka, in the year 1994. Dissociative disorder (Hysteria) comprised the largest group (21.65%), followed by epilepsy (19.59%). Majority of the cases were within 7-10 years age group with mean age 9.74 (+/- 2.39) years. Male outnumbered female patients and 53.61% cases came from rural background. The findings of the study indicate the need for establishment of child psychiatric treatment centres in different parts of the country including rural areas.

Las interconsultas psiquiátricas: Análisis y comparaciones / Psiquiatric consult: Analysis and comparison

Presentamos una revisión de 724 interconsultas psiquiátricas enviadas al servicio de psiquiatría de un hospital general durante el período de Abril de 1984 a Abril de 1988. Los resultados son analizados y comparados con otras publicaciones nacionales y extranjeras, invocándose medidas para mejorar los criterios diagnósticos y el análisis de los mismos

An epidemic of illness in an Indian telephone exchange.

In January and February 1987 an epidemic of a strange illness involving 31 members of the staff in the Calcutta Telephone Exchange occurred. It commenced in the "operator services" on the 4th floor and after involving 21 members of the staff, progressed to the 6th floor where a further 10 members of the staff were involved. The symptoms varied and included a burning feeling on the face, weakness of the limbs, noises in the ear and heaviness of the head. In most cases no physical injury was found and a psychological disorder occurred subsequently in a few cases. Extensive investigation of the network did not reveal any specific electronic causes although some defects were found. The likely causative factors were poor ventilation causing a mild excess of CO2 as well as a mild heat load, overlaid on a background of work stress. The epidemic was exacerbated by erroneous reports in the media and by rumour that the members of the staff admitted to hospital were permanently injured. The epidemic abated in conjunction with steps to improve the work environment and to improve medical communication. The epidemic is discussed with regard to mass sociogenic illness.

Hysteria in children and adolescents.

Thirty eight cases of childhood hysteria admitted to a rural medical college hospital, were studied for epidemiological characteristics, clinical presentation, precipitating factors and psychosocial environment and behaviour. Hysteria was commonly seen during adolescence (73.2%) and in males (63.2%). It was more common in the lower socio-economic status (60.5%) and in children for nuclear (94.7%) and large size families (81.6%). Eldest or youngest siblings of the families were found to be more prone to develop hysteria. Motor symptoms were most frequently observed (71.1%) and 55.3% cases had more than one symptom at the time of presentation. In a majority of cases hysteria was acute in onset. Precipitating psychological event was identified in 81.6% cases; scolding (26.3%) being the commonest followed by school avoidance (13.2%), examination fear (10.5%) and quarrel with peers (10.5%). Past history of 52.6% of patients of hysteria and 18.4% of their parents revealed subtle behavioural abnormalities. All patients improved with psychotherapy and modification of the psychosocial environment.