Koro epidemics in Guangdong, China. A questionnaire survey.

Koro epidemics, characterized by panic due to fear of genital retraction, involving more than 2000 victims, mainly young men, occurred in Hainan Island and Leizhou Peninsula of Guangdong Province, China, in 1984-85 and 1987. A questionnaire survey of 214 victims of these epidemics was conducted in 1988. The survey focused on symptom manifestation, personality profile, life problems, and folk belief. The results of the "koro" group were compared with those of a "clinic" group with minor psychiatric disorder and a "control" group from the non-clinical, non-koro episode population in the epidemic area. The results revealed that the victims of the koro epidemics were characterized by low intellectual endowment and strong acceptance of koro-related folk beliefs. The results support the hypotheses that: a) a koro attack is a psychologically induced anxiety-panic condition; b) the presence of an intensive belief in the culturally related concept of koro makes the subject vulnerable to the attack; and c) social crisis or tension serves as a trigger for the occurrence of the epidemic.

A sociocultural study of koro epidemics in Guangdong, China.

Koro, a culture-related psychiatric disorder characterized by panic due to fear of genital retraction, occurred as the rare phenomenon of koro epidemics in a remote region of Guangdong, China, in 1984-1985 and 1987. The sociocultural and historical backgrounds of the area are described. The life pattern and attitudes toward supernatural beings and the commonly shared folk belief of evil-induced genital retraction were considered grounds for the panic, while the community's anxious reaction and hysterical atmosphere facilitated the intensification and recurrence of the episodes. Geographic seclusion associated with localism in folk beliefs and practices may have kept the epidemics confined to the region.

Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel.

Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. Death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. Death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.