Transculturation, psychosis and koro symptoms.

Koro is a clinical syndrome characterized by the conviction of penile retraction and fear of inevitable death upon its disappearance into the abdomen. The syndrome is generally considered culture bound, yet an increasing number of sporadic cases were attributed to psychiatric, systemic or neurologic pathology. In the following article, sporadic koro cases associated with paranoid psychosis or schizophrenia have been assembled, indicating that immigration is an important factor in the pathogenesis of the clinical phenomenon. The interplay between psychosis, transculturation and cultural influence affecting koro development is discussed.

Changes in attitudes of medical students towards psychiatry: an evaluation of a clerkship in psychiatry.

The attitudes to psychiatry of medical students before and after their clinical rotation in psychiatry were assessed during the course of the academic year 1989-1990 by a questionnaire administered before and after the clerkship. Analysis of the data indicated that although there was no major shift in attitudes, the clerkship did succeed in improving clinical skills such as the capability for a better understanding of patients and the improvement of doctor-patient relations, as well as giving the student a more realistic approach to the diagnosis, treatment and prognosis of mentally ill patients.

Phenothiazine-associated supraventricular tachycardia.

Psychotropic medications, mainly phenothiazines, are known to be associated with cardiac insult. The case report presented here describes nearly fatal arrhythmia (sustained supraventricular tachycardia) consequent to phenothiazine treatment. The authors aim to alert psychiatrists to the possible adverse, and even fatal, effects of phenothiazines.

[Koro syndrome--clinical and cultural aspects].

Koro syndrome is a triad which includes a deep-seated fear that the penis will shrink, disappear into the abdomen, and that death will follow. The patient experiences profound anxiety and performs preventive manoeuvres, such as pulling his penis outward. The disorder is considered culture-related, and is endemic in South-East Asia and China, where it occurs in epidemic and sporadic forms. Sporadic cases appear in the western hemisphere, often in association with an underlying psychiatric or organic disorder, usually of the central nervous system. 6 cases of koro have been published from Israel.

Integration of cultural elements in the therapeutic milieu of a psychiatric day care unit.

For comprehensive understanding of a patient's mental crisis, a thorough knowledge of his cultural context is valuable, as this affords reciprocal translation of the patient's and therapist's codes. Elucidation of the cultural context belongs to the domain of clinical anthropology. In our Day Care Unit we utilize an ethno-psychiatric approach. The anthropologist employs the life-cycle method and a health/illness questionnaire. The former consists of a chronological narration of the patient's life events as rendered by him. Integration of this anthropological material with the anamnestic data is time saving, in that it furnishes the therapist with the opportunity to determine the focus of dynamic therapy already in an early phase of the treatment. The aim of the health/illness questionnaire is to discover the patient's conception of sickness in general and of his mental illness in particular. The information gathered by this anthropological tool guides the therapist in planning the appropriate treatment strategy, while at the same time it may predict the patient's compliance.

The disorder named koro.

The koro syndrome is a triad of deep-seated fear of penile shrinkage, its disappearance into the abdomen and consequent death. The disorder, which is considered culture related, is endemic in South-East Asia and China, where it occurs in both epidemic and sporadic form. In the western hemisphere single cases are occasionally encountered. The association with psychiatric pathology in sporadic cases of koro has been well described, but lately attention has been drawn to systemic or neurologic involvement in these patients. The clinical, historical and cultural features of koro, as well as therapeutic strategies, are discussed.

Koro secondary to a tumour of the corpus callosum.

The concurrent appearance of the koro syndrome and pathology of the central nervous system is quite rare. A case of a patient with a diagnosed tumour in the genu of the corpus callosum, who displayed typical koro symptoms, is presented. A short series of electroconvulsive shock treatments brought about resolution of the koro symptoms. Neurological investigation of all sporadic cases of koro is deemed necessary, to exclude cerebral involvement.