Koro in Females: An Analysis of 48 Cases

Koro (genital retraction syndrome) is a culture-linked psychogenic reactive state. In females, the cardinal symptom is the perception of retraction or shrinkage of nipple or breast mass into the chest cavity or of labia into the abdomen with acute fear of either imminent death or sexual invalidism. This paper is the first attempt in the world literature to explore the detailed clinical characteristics of koro in 48 females drawn from an epidemic in India.

An Atypical Hysteria Epidemic in Tripura, India

This paper reports an atypical hysteria epidemic in a tribal village of the State of Tripura, India. Twelve persons, eight female and four male, were affected in a chain reaction within a span of ten days. The cardinal feature was an episodic trance state of 5 to 15 minutes duration with restlessness, attempts at self-injury, running away, inappropriate behaviour, inability to identify family members, refusal of food and intermittent mimicking of animal sounds. The illness was self-limiting and showed an individual course of one to three days duration. Sociocultural aspects of the epidemic are discussed.

The definition and classification of Koro

Attempts at defining and classifying Koro have been undertaken by various researchers over at least the last fifty years without any consensus emerging to date. The occurrence of Koro, not only in different parts of the world but also in association with varied morbidities, has of late diluted its primary identity as a culture-bound syndrome. Further, the DSM-IIIR and ICD-10 provisions to include culture-bound syndromes like Koro are open to various diagnostic options. Consideration was given to have it included in DSM-IV. One of the fundamental problems inherent in such attempts is the semantic confusion Koro generates in its basic phenomenological analysis. The present paper deals with some of these issues based on historical analysis of world Koro literature, and with comments on the future research agendum.

Comment: the neglect of culture in psychiatric nosology: the case of culture bound syndromes

Descriptive psychopathology and clinical phenomenology inform contemporary psychiatric diagnosis and nosology. The process of psychiatric diagnosis and classification is intricate and subject to continuous revision. This paper attempts to illustrate the effect of culture on psychopathology, with special emphasis on the diagnosis and classification of culture bound syndromes. There is a need for more clarity and specificity about the diagnosis and classification of culture bound syndromes. The paper suggests some questions that need to be addressed for the better integration of these syndromes into the main body of international classificatory systems. It is presumed that answers to these questions will provide a better nosological framework for culture bound syndromes.