1
|
Hartung K, Klages C, Fremer C, Pisarenko A, Haas M, Jakubovski E, Szejko N, Brandt V, Müller-Vahl KR. Prevalence of mass social media-induced illness presenting with Tourette-like behavior in Germany between 2019 and 2021. J Psychiatr Res 2024; 177:234-238. [PMID: 39033669 DOI: 10.1016/j.jpsychires.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/30/2024] [Accepted: 07/10/2024] [Indexed: 07/23/2024]
Abstract
Starting in 2019, in Germany the first well documented outbreak of mass sociogenic illness induced by social media (mass social media-induced illness; MSMI) occurred presenting with functional Tourette-like behaviors (FTB). This study aimed to provide first data on the prevalence rate of MSMI-FTB in Germany between 2019 and 2021 in the general population. We conducted a large-scale representative population survey in cooperation with the USUMA market and social research institute. Between August and December 2021, n = 2.509 people (mean age: 49.5 years, range: 16-95 years, n = 1.276 females) were randomly selected, visited in their households, interviewed, and asked to answer for themselves, but also for close family members (n = 6.744). Thus, in total, we received answers for n = 9.253 people. Probable MSMI-FTB was found in n = 33 individuals (mean age at onset: 30.5 years, n = 8 females). Based on strict criteria, the diagnosis of MSMI-FTB was considered highly likely in 16/33 individuals (mean age at onset: 25.6 years, n = 2 females) corresponding to prevalence rates of 0.17% (CIlower = 0.10, CIupper = 0.28) and 0.36% (CIlower = 0.25, CIupper = 0.50), respectively. This is the first large-scale, population representative study investigating the prevalence of MSMI-FTB in the general population in Germany between 2019 and 2021. Based on the prevalence rates found, MSMI-FTB is highly relevant for health economy. Accordingly, we suggest educating healthcare professionals and the general public to avoid misdiagnosis and inefficient treatment.
Collapse
Affiliation(s)
- Kathrin Hartung
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Carolin Klages
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Carolin Fremer
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Anna Pisarenko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Martina Haas
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Ewgeni Jakubovski
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Natalia Szejko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany; Department of Clinical Neurosciences, University of Calgary, Alberta, Canada; Department of Bioethics, Medical University of Warsaw, Poland
| | - Valerie Brandt
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany; School of Psychology, Centre for Innovation in Mental Health, University of Southampton, UK
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
| |
Collapse
|
2
|
Saunders C, Tan W, Faasse K, Colagiuri B, Sharpe L, Barnes K. The effect of social learning on the nocebo effect: a systematic review and meta-analysis with recommendations for the future. Health Psychol Rev 2024:1-20. [PMID: 39205378 DOI: 10.1080/17437199.2024.2394682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
ABSTRACTIndividuals frequently update their beliefs and behaviours based on observation of others' experience. While often adaptive, social learning can contribute to the development of negative health expectations, leading to worsened health outcomes, a phenomenon known as the nocebo effect. This systematic review and meta-analysis examined: whether social learning is sufficient to induce the nocebo effect, how it compares to other forms of induction (classical conditioning and explicit instruction), and factors that influence these effects. The meta-analysis included twenty studies (n = 1388). Social learning showed a medium-large effect size (Hedges' g = .74) relative to no treatment and a to small-medium effect (g = .42) when compared to neutral modelling. The effect of social learning was similar in magnitude to classical conditioning but greater than explicit instruction with a small-medium effect (g = .46). Face-to-face social modelling, longer exposure, higher proportions of female participants and models, and greater observer empathy led to stronger socially-induced nocebo effects. However, further research is essential as only a minority of studies measured important constructs like negative expectancies and state anxiety. Nonetheless, the study highlights social learning as a key pathway for nocebo effects, suggesting it as a target for interventions to reduce the substantial personal and societal burden caused by nocebo effects.
Collapse
Affiliation(s)
- Cosette Saunders
- School of Psychology, University of Sydney, Camperdown, Australia
| | - Winston Tan
- School of Psychology, University of Sydney, Camperdown, Australia
| | - Kate Faasse
- School of Psychology, University of New South Wales, Kensington, Australia
| | - Ben Colagiuri
- School of Psychology, University of Sydney, Camperdown, Australia
| | - Louise Sharpe
- School of Psychology, University of Sydney, Camperdown, Australia
| | - Kirsten Barnes
- School of Psychology, University of New South Wales, Kensington, Australia
| |
Collapse
|
3
|
Salzberg MR, Kim H, Basnayake C, Holt D, Kamm MA. Role of social media in the presentation of disorders of gut-brain interaction: Review and recommendations. J Gastroenterol Hepatol 2024. [PMID: 39073170 DOI: 10.1111/jgh.16698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
As clinicians involved in the care of patients with disorders of gut-brain interaction (DGBIs), we-and many colleagues-have the impression that social media are adversely shaping the nature, presentation, and ability to manage these disorders, especially at the severe end of the DGBI clinical spectrum. We turned to the research literature to see if these clinical impressions were corroborated but found it virtually nonexistent. Social media have rapidly become a ubiquitous, pervasive part of the lives of most people on the planet. Although they bring many benefits, they are also replete with health misinformation, reinforcement of abnormal sick-role behavior, and undermining of the legitimacy of psychological care. We first set out four reasons for concern about social media and DGBIs, particularly severe DGBIs. These reasons stem from phenomena described in medical fields outside DGBIs, but there is no reason to think DGBIs should be exempt from such phenomena. We then present the results of a literature search, which yielded only eight disparate recent empirical studies. We review these studies, which, although not uninformative, reveal a field in its infancy. We set out implications, most urgently multidisciplinary research directly addressing the role of social media and evaluation of interventions to mitigate its ill effects. Gastroenterological clinicians involved in DGBI care and research need to collaborate with experts in social media research, which is a very rapidly evolving, specialized field. Although knowledge is at an early stage, there are implications for specialist practice, education and training, and DGBI service delivery.
Collapse
Affiliation(s)
- Michael R Salzberg
- Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Hannah Kim
- Medical Stream Lead, Eating Disorders, Orygen Specialist Program, Melbourne, Victoria, Australia
| | - Chamara Basnayake
- St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - Darcy Holt
- Clinical Nutrition and Metabolism Unit and Department of Gastroenterology and Hepatology, Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Michael A Kamm
- St Vincent's Hospital and University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
4
|
Cavanna AE, Spini L, Ferrari S, Purpura G, Riva A, Nacinovich R, Seri S. Functional Tic-like Behaviors: From the COVID-19 Pandemic to the Post-Pandemic Era. Healthcare (Basel) 2024; 12:1106. [PMID: 38891181 PMCID: PMC11171709 DOI: 10.3390/healthcare12111106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
During the COVID-19 pandemic, there have been multiple reports about an unforeseen surge in adolescents and young adults exhibiting sudden onset functional tic-like behaviors. This phenomenon has been mainly associated with the female gender and occasionally after exposure to social media content featuring similar patterns of functional tic-like behaviors. A significant portion of these individuals have been directed to specialist clinics for movement disorders with initial misdiagnoses of late-onset refractory Tourette syndrome. Distinguishing between rapid onset functional tic-like behaviors and neurodevelopmental tics as part of Tourette syndrome can be challenging; however, the differential diagnosis is facilitated by focusing on specific clinical and demographic factors, which we have explored in a systematic literature review. Compared to neurodevelopmental tics, functional tic-like behaviors typically present with a more abrupt and intense manifestation of symptoms, onset at a later age, higher prevalence among females, inability to suppress tics, coexisting anxiety and depression, and sometimes a history of exposure to social media content portraying tic-like behaviors of a similar nature. This novel manifestation of a functional neurological disorder may thus be viewed as an emerging neuropsychiatric condition potentially triggered/exacerbated by the psychosocial repercussions of the COVID-19 crisis.
Collapse
Affiliation(s)
- Andrea Eugenio Cavanna
- Department of Neuropsychiatry, National Centre for Mental Health, BSMHFT and University of Birmingham, Birmingham B15 2FG, UK
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham B4 7ET, UK
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London WC1E 6BT, UK
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Laura Spini
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Silvia Ferrari
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Giulia Purpura
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Anna Riva
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Renata Nacinovich
- Department of Child Neuropsychiatry, IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20125 Milan, Italy
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham B4 7ET, UK
| |
Collapse
|
5
|
Pilotto A, Catania M, Mattioli I, Zoppi N, Ceccardi G, Rao R, Gipponi S, Magoni M, Gamba M, Padovani A. Increased risk of functional neurological disorders following SARS-CoV-2 vaccination. Eur J Neurol 2024; 31:e16191. [PMID: 38165067 PMCID: PMC11235690 DOI: 10.1111/ene.16191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to evaluate the possible correlation between SARS-CoV-2 vaccines and the onset of neurological syndromes. The aim was to challenge the association between SARS-CoV-2 vaccinations and the onset of acute functional neurological disorders (FNDs) compared to other neurological syndromes in hospitalized patients. METHODS In this prospective cohort study, all adult inpatients consecutively admitted to a tertiary neurological centre were included. The prevalence and characteristics of neurological syndromes were compared between unvaccinated and vaccinated cases stratified according to the onset from vaccination. The study involved 843 subjects, namely 411 unvaccinated (UVC) and 432 vaccinated cases; these groups were comparable for demographics and clinical diagnosis distribution. RESULTS Compared to UVC, subjects hospitalized within the first 30 days from vaccine exhibited higher prevalence of FNDs (12.3% vs. 3.6%; odds ratio 4.2, 95% confidence interval 1.6-11.1) and headache (10.8% vs. 5%; odds ratio 4.1, 95% confidence interval 1.9-8.8) but no other neurological syndromes. The FND cases following vaccinations showed similar premorbid conditions and severity but a higher percentage of sensory symptoms and pain compared to UVC FND cases. CONCLUSIONS SARS-CoV-2 vaccination is associated with a significant short-term increased risk of FND and headache requiring hospitalization in an acute neurological setting.
Collapse
Affiliation(s)
- Andrea Pilotto
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Laboratory of Digital Neurology and BiosensorsUniversity of BresciaBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Marcello Catania
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Laboratory of Digital Neurology and BiosensorsUniversity of BresciaBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Irene Mattioli
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Nicola Zoppi
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Giulia Ceccardi
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Renata Rao
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
| | - Stefano Gipponi
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
| | - Mauro Magoni
- Stroke UnitASST Spedali Civili of BresciaBresciaItaly
| | - Massimo Gamba
- Stroke UnitASST Spedali Civili of BresciaBresciaItaly
| | - Alessandro Padovani
- Neurology Unit, Department of Continuity of Care and FrailtyASST Spedali Civili Brescia HospitalBresciaItaly
- Laboratory of Digital Neurology and BiosensorsUniversity of BresciaBresciaItaly
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Brain Health CenterUniversity of BresciaBresciaItaly
| |
Collapse
|
6
|
Tomczak KK, Worhach J, Rich M, Swearingen Ludolph O, Eppling S, Sideridis G, Katz TC. Time is ticking for TikTok tics: A retrospective follow-up study in the post-COVID-19 isolation era. Brain Behav 2024; 14:e3451. [PMID: 38468457 PMCID: PMC10928347 DOI: 10.1002/brb3.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/29/2023] [Accepted: 02/06/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, an influx of adolescents presented worldwide with acute onset of functional tic-like behaviors (FTLBs). Our goal was to evaluate psychosocial factors around onset, to elucidate outcomes after pandemic isolation protocols were lifted, and to examine therapy and medication management. METHODS A retrospective review was performed of 56 patients ages 10-18 years with new-onset FTLBs seen at Boston Children's Hospital beginning in March 2020. Demographic factors, medical history, and treatment were evaluated. Patient outcomes were determined retrospectively based on the Clinical Global Impression Improvement (CGI-I) and Severity (CGI-S) scales from follow-up visits. CGI-I scores assessed the progression of FTLBs; CGI-S assessed overall function. RESULTS Ninety-six percent of patients were female-assigned at birth with high rates of comorbid anxiety (93%) and depression (71%). Forty-five percent were gender-diverse. Based on scales that assessed FTLBs (CGI-I) and overall functioning (CGI-S), up to 79% of patients improved independent of comorbid diagnosis or treatment. Evidence-based tic-specific treatments were not more effective than other treatments. A subset of patients had improvement in their FTLBs but not in their general functioning and continued to have other psychosomatic presentations. CONCLUSION While many patients' FTLBs improved, it is critical to remain alert to patients' overall function and to assess for other functional neurological disorders and mental health concerns. The tendency of FTLBs to improve in this population, independent of treatment, highlights the unique pathophysiology of FTLBs. Future research on contributing psychosocial factors and specific treatment protocols will allow optimal support for these patients.
Collapse
Affiliation(s)
- Kinga K. Tomczak
- Tic Disorders and Tourette Syndrome Program, Department of NeurologyBoston Children's HospitalBostonMassachusettsUSA
| | - Jennifer Worhach
- Tic Disorders and Tourette Syndrome Program, Department of NeurologyBoston Children's HospitalBostonMassachusettsUSA
| | - Michael Rich
- Clinic for Interactive Media and Internet Disorders (CIMAID) and Digital Wellness Lab, Division of Adolescent/Young Adult MedicineBoston Children's HospitalBostonMassachusettsUSA
| | - Olivia Swearingen Ludolph
- Tic Disorders and Tourette Syndrome Program, Department of NeurologyBoston Children's HospitalBostonMassachusettsUSA
| | - Susan Eppling
- Occupational TherapyOnline OTs, and CBIT TherapyBostonMassachusettsUSA
| | - Georgios Sideridis
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational ResearchBoston Children's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Tamar C. Katz
- Department of PsychiatryBoston Children's HospitalBostonMassachusettsUSA
| |
Collapse
|
7
|
Quinn V, Pearson S, Huynh A, Nicholls K, Barnes K, Faasse K. The influence of video-based social modelling on the nocebo effect. J Psychosom Res 2023; 165:111136. [PMID: 36610337 DOI: 10.1016/j.jpsychores.2022.111136] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Seeing someone else experience side effects (i.e., social modelling) can increase negative expectations and subsequent nocebo effects. In face-to-face contexts, this effect appears stronger in female participants. Less is known about the influence of gender on negative expectations and nocebo effects generated via video-based social modelling. METHODS One hundred and seven undergraduate participants recruited from a participant pool at an Australian university took part in a study ostensibly investigating the influence of beta-blocker medications (actually a sham treatment) on physiological and psychological aspects of anxiety. Participants were randomly assigned to either a no-treatment control group, a standard treatment group, or a video modelling group, in which participants viewed video-recorded confederates (one male, one female) report experiencing four side effects (two each) after taking the study treatment. Symptoms were assessed 15-min following pill ingestion, and at follow-up 24 h later. RESULTS Video modelling of side effects, compared to standard treatment, interacted with gender and was associated with increased reporting of modelled symptoms in female compared to male participants, p = .01, ηp2=0.06. Video modelling also increased negative expectations in female compared to male participants, p = .03, ηp2=0.07, and expectations mediated the influence of modelling on modelled symptoms in female participants. CONCLUSIONS Social modelling of side effects via video increased negative expectations, and nocebo symptoms, to a greater extent in female participants. These findings suggest that males and females are differentially impacted by video-based side effect modelling. Results have implications for social modelling of side effects via social media and patient-support websites.
Collapse
Affiliation(s)
- Veronica Quinn
- Department of Psychology, Macquarie University, Australia
| | - Sarah Pearson
- School of Psychology, University of New South Wales, Australia
| | - Anna Huynh
- School of Psychology, University of New South Wales, Australia
| | - Kate Nicholls
- School of Psychology, University of New South Wales, Australia
| | - Kirsten Barnes
- School of Psychology, University of New South Wales, Australia
| | - Kate Faasse
- School of Psychology, University of New South Wales, Australia.
| |
Collapse
|
8
|
Firestone MJ, Holzbauer S, Conelea C, Danila R, Smith K, Bitsko RH, Klammer SM, Gingerich S, Lynfield R. Rapid onset of functional tic-like behaviors among adolescent girls-Minnesota, September-November 2021. Front Neurol 2023; 13:1063261. [PMID: 36742058 PMCID: PMC9892901 DOI: 10.3389/fneur.2022.1063261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
Background On October 15, 2021, the Minnesota Department of Health began investigating a school cluster of students experiencing tic-like behaviors thought to be related to recent COVID-19. The objective of this report is to describe the investigation, key findings, and public health recommendations. Methods Affected students and proxies were interviewed with a standardized questionnaire including validated depression and anxiety screens. Results Eight students had tic-like behaviors lasting >24 h after initial report with onset during September 26-October 30, 2021. All eight students were females aged 15-17 years. All students either had a history of depression or anxiety or scored as having more than minimal anxiety or depression on validated screens. Four students previously had confirmed COVID-19: the interval between prior COVID-19 and tic symptom onset varied from more than a year prior to tic symptom onset to at the time of tic symptom onset. Conclusion The onset of tic-like behaviors at one school in Minnesota appeared to be related more to underlying mental health conditions than recent COVID-19. These findings highlight the need to better understand functional tic-like behaviors and adolescent mental health.
Collapse
Affiliation(s)
- Melanie J. Firestone
- Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States,Minnesota Department of Health, St. Paul, MN, United States,*Correspondence: Melanie J. Firestone ✉
| | - Stacy Holzbauer
- Minnesota Department of Health, St. Paul, MN, United States,Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Christine Conelea
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Richard Danila
- Minnesota Department of Health, St. Paul, MN, United States
| | - Kirk Smith
- Minnesota Department of Health, St. Paul, MN, United States
| | - Rebecca H. Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | | | | | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, MN, United States
| |
Collapse
|
9
|
Giedinghagen A. The tic in TikTok and (where) all systems go: Mass social media induced illness and Munchausen's by internet as explanatory models for social media associated abnormal illness behavior. Clin Child Psychol Psychiatry 2023; 28:270-278. [PMID: 35473358 DOI: 10.1177/13591045221098522] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This paper explores the recent phenomenon of adolescents presenting en masse (both online and in clinical settings) with symptoms seemingly acquired from viewing illness-related content posted by social media influencers. The most frequently reproduced illnesses have included Dissociative Identity Disorder (DID) and Tourette Syndrome. It discusses evidence that the recent spate of new-onset, severe tics are a form of Mass Psychogenic Illness facilitated by social media networks (a phenomenon labeled Mass Social Media Induced Illness). It then suggests that many of those self-diagnosed with DID may be manifesting a similar, technologically-facilitated conversion phenomenon. It then explores another explanatory model: that these simulacra of DID and Tourette Syndrome may also arise via a mechanism more closely resembling social media facilitated Factitious Disorder. Similar presentations, of individuals falsifying cancer, have previously been labeled Munchausen's by Internet. It then proposes an overarching construct, Social Media Associated Abnormal Illness Behavior (SMAAIB), that is agnostic regarding phenomenology. Within this framework, it explores the ways in which de-commodifying attention, connection and care (measured once in appointments and admissions, now in 'likes' and 'shares') and obtaining a full picture of the patient's psychological, sociological and cultural grounding can offer deeper understanding and ultimately a path to wellness.
Collapse
Affiliation(s)
- Andrea Giedinghagen
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, 12275Washington University in St Louis School of Medicine, St Louis, MO, USA
| |
Collapse
|
10
|
Muacevic A, Adler JR, Kakkar R, Aravindakshan R, Tripathi M, Ayyanar R, V M. Mysterious Outbreak of Acute Neurological Syndrome in Eluru, Andhra Pradesh, India: A Post-outbreak Geo-Spatial Analysis. Cureus 2022; 14:e31801. [PMID: 36569687 PMCID: PMC9780085 DOI: 10.7759/cureus.31801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND An outbreak characterized by sudden-onset seizures, loss of consciousness, and complete recovery within a few hours was reported from Eluru town in Andhra Pradesh on December 6, 2020. This study was conducted to assess the environmental correlates of the outbreak using geo-mapping tools. METHODS A post-outbreak survey was conducted among affected cases in January-February, 2021. A house-to-house survey tool collected information on demographics, clinical profile, and environmental and psychological aspects (Impact of Event Scale). Geo-mapping and news media content analyses were done using QGIS and Atlas.ti software, respectively. RESULTS A total of 394 cases were studied. The median (interquartile range [IQR]) age of the participants was 27 (17-39) years and comprised mostly male students. There was no clustering of cases within 48 hours of illness onset in the spatial analysis. Loss of consciousness was the first (50.7%) and the most common symptom. All cases were taken to a health facility and were discharged after a median duration of 48 minutes. COVID-19-related and environmental practices were not associated with the clinical manifestations. Awareness about pesticides was low. The outbreak reportedly had a psychological impact on 24.4% of the participants. The most common co-occurring themes in the news media analysis were water contamination and pesticides. CONCLUSION The geo-spatial analysis did not find case clustering or points of convergence during the incubation period. The geo-locations did not distribute around water bodies or suspected landmarks although news media projected water contamination and pesticides as probable causes of the outbreak.
Collapse
|
11
|
Larson HJ, Lin L, Goble R. Vaccines and the social amplification of risk. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:1409-1422. [PMID: 35568963 PMCID: PMC9347756 DOI: 10.1111/risa.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/20/2022] [Accepted: 03/06/2022] [Indexed: 05/13/2023]
Abstract
In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy. However, hesitancy concerning these vaccines, along with resistance to masking and other control measures, remains a substantial obstacle. The previous waves of vaccine hesitancy that led to the WHO threat designation, together with recent COVID-19 experience, provide a window for viewing new forms of social amplification of risk (SAR). Not surprisingly, vaccines provide fertile ground for questions, anxieties, concerns, and rumors. These appear in new globalized hyperconnected communications landscapes and in the context of complex human (social, economic, and political) systems that exhibit evolving concerns about vaccines and authorities. We look at drivers, impacts, and implications for vaccine initiatives in several recent historical examples and in the current efforts with COVID-19 vaccination. Findings and insights were drawn from the Vaccine Confidence Project's decade long monitoring of media and social media and its related research efforts. The trends in vaccine confidence and resistance have implications for updating the social amplification of risk framework (SARF); in turn, SARF has practical implications for guiding efforts to alleviate vaccine hesitancy and to mitigate harms from intentional and unintentional vaccine scares.
Collapse
Affiliation(s)
- Heidi J. Larson
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Deparment of Health Metrics SciencesUniversity of WashingtonSeattleWashingtonUSA
| | - Leesa Lin
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Laboratory of Data Discovery for Health Limited (D24H)Hong Kong Science Park, Hong Kong Special Administrative Region, China
- School of Public HealthThe University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rob Goble
- George Perkins Marsh InstituteClark UniversityWorcesterMassachusettsUSA
| |
Collapse
|
12
|
Siamisang K, Phologolo T, Mukuhwa T, Schafrick N, Mhaladi B, Phuthego B, Mmati M, Masupe T. Predictors of mass psychogenic illness in a junior secondary school in rural Botswana: A case control study. S Afr J Psychiatr 2022; 28:1671. [PMID: 35747341 PMCID: PMC9210177 DOI: 10.4102/sajpsychiatry.v28i0.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background In March 2019, students at Lempu Secondary School in Kweneng District, Botswana displayed symptoms including headache, abnormal leg movements and difficulty walking. Within days, 133 students were admitted to Scottish Livingstone Hospital where mass psychogenic illness (MPI) was diagnosed. Aim To identify predictors of this illness. Setting Kweneng West District, Botswana. Methods This was a case control study using interviewer-administered questionnaires. Cases were students who displayed MPI symptoms from the 2nd of March to the time of the interviews or who were admitted with MPI diagnosis. Analysis was restricted to female students. Logistic regression was used to generate odds ratios. A p value of < 0.05 was considered to demonstrate significant association between variables. Results Interviews were conducted with 142 cases and 202 controls. The median age was 15 years. Most of the cases (95.8%) were boarding girls. Residence in school campus (AOR 13.2), history of evaluation by psychologist and/or social worker (AOR 2.6), history of traumatic events (AOR 1.8), contact with sick peers (AOR 2.3) and contact with spiritual healer (AOR 2.0) were independent predictors of MPI. Additionally, perception of adequate security in the dormitories (AOR 0.3) and perception of poor lighting (AOR 6.8) were significant predictors of MPI amongst boarding girls. Conclusion The outbreak in Lempu Community Junior Secondary School (CJSS) was typical of mass psychogenic illness affecting mainly boarding girls and was associated with psychological and environmental risk factors. Changing the boarding environment and continuous psychological support are key to preventing future outbreaks. Interventions should also target the identified risk factors.
Collapse
Affiliation(s)
- Keatlaretse Siamisang
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Thabo Phologolo
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Terrence Mukuhwa
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Nathaniel Schafrick
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Vermont, Vermont, United States of America
| | - Bonolo Mhaladi
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Boang Phuthego
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Monica Mmati
- Department of Health Services Management, Ministry of Health and Wellness, Gaborone, Botswana
| | - Tiny Masupe
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| |
Collapse
|
13
|
Zea Vera A, Bruce A, Garris J, Tochen L, Bhatia P, Lehman RK, Lopez W, Wu SW, Gilbert DL. The Phenomenology of Tics and Tic-Like Behavior in TikTok. Pediatr Neurol 2022; 130:14-20. [PMID: 35303587 DOI: 10.1016/j.pediatrneurol.2022.02.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/06/2022] [Accepted: 02/20/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Pediatricians and pediatric subspecialists worldwide have reported a marked increase in functional (conversion) disorders with tic-like behaviors during the COVID-19 pandemic. These patients often report frequent viewing of Tourette syndrome (TS) TikTok videos, suggesting disease modeling. We aimed to evaluate tic phenomenology in videos posted on TikTok. METHODS The 100 most-viewed videos under #tourettes in TikTok were randomly assigned to two of three primary reviewers (<2 years independent practice), all pediatric neurologists specializing in movement disorders, for extraction and classification of tic phenomenology. Initial disagreements were solved by consensus. If not resolved, one of five senior reviewers (>2 years independent pediatric movement disorder practice) served as a tiebreaker. In addition, two primary and one senior reviewer rated each video on a Likert scale from 1 = "All the tics are typical of TS" to 5 = "None of the tics are typical of TS". Median scores and Spearman correlation between primary and senior reviewers were calculated. RESULTS Six videos without tic-like behaviors were excluded. Most videos depicted coprophenomena (coprolalia: 53.2%; copropraxia: 20.2%), often with unusual characteristics. Frequently, videos demonstrated atypical phenomenology such as very strong influence by the environment (motor: 54.3%; phonic: 54.3%), aggression (19.1%), throwing objects (22.3%), self-injurious behaviors (27.7%), and long phrases (>3 words; 45.7%). Most videos portrayed atypical, nontic behaviors (median [IQR] Likert ratings: 5 [4-5]). Primary vs. senior rater scores demonstrated moderate agreement (r = 0.46; P < 0.001). CONCLUSIONS TS symptom portrayals on highly viewed TikTok videos are predominantly not representative or typical of TS.
Collapse
Affiliation(s)
- Alonso Zea Vera
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Neurology, Children's National Hospital, Washington, District of Columbia.
| | - Adrienne Bruce
- Department of Pediatrics, Prisma Health, Greenville, South Carolina; University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Jordan Garris
- Department of Neurology, University of Virginia Medical Center, Charlottesville, Virginia
| | - Laura Tochen
- Department of Neurology, Children's National Hospital, Washington, District of Columbia
| | - Poonam Bhatia
- Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, Arizona
| | - Rebecca K Lehman
- Prisma Health-Midlands, Columbia, South Carolina; Department of Neurology, University of South Carolina, Columbia, South Carolina
| | - Wendi Lopez
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Steve W Wu
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Donald L Gilbert
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
14
|
Martindale JM, Mink JW. The Rise of Functional Tic-Like Behaviors: What Do the COVID-19 Pandemic and Social Media Have to Do With It? A Narrative Review. Front Pediatr 2022; 10:863919. [PMID: 35899132 PMCID: PMC9309505 DOI: 10.3389/fped.2022.863919] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There has been a rise in explosive onset of tic-like behaviors during the COVID-19 pandemic. Historically, this is an uncommon phenomenology of functional movement disorders across all ages. Both the psychological burden of the pandemic and social media usage have been implicated in the rise of these tic-like behaviors. METHODS This paper provides a narrative review of the literature on chronic tic disorders, functional tics, and mass functional illness with particular focus on the key distinguishing features, role of social media, and the role of COVID-19. RESULTS The COVID-19 pandemic has profoundly affected the mental health of many individuals, including children, adolescents, and their caregivers. Implementation of lockdowns, lifestyle disruptions, school closures, and social distancing have driven a surge in social media and digital technology use. The combination of predisposing factors, the psychological burden of the COVID-19 pandemic, and social media are implicated in the rise and spread of tic-like behaviors; which may represent a modern-day form of mass functional illness. While many of the features overlap with functional tics, there are emerging distinctive features that are important to recognize. A more encompassing term, Functional Tic-Like Behaviors, is used to better reflect multiple contributing factors. CONCLUSION Knowledge of these differences is essential to mitigate downstream health effects and poor outcomes.
Collapse
Affiliation(s)
- Jaclyn M Martindale
- Department of Neurology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, NC, United States
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| |
Collapse
|
15
|
Fremer C, Szejko N, Pisarenko A, Haas M, Laudenbach L, Wegener C, Müller-Vahl KR. Mass social media-induced illness presenting with Tourette-like behavior. Front Psychiatry 2022; 13:963769. [PMID: 36203825 PMCID: PMC9530444 DOI: 10.3389/fpsyt.2022.963769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/02/2022] [Indexed: 11/22/2022] Open
Abstract
Currently, we are facing a new manifestation of functional neurological disorder presenting with functional Tourette-like behavior (FTB). This study aimed to show characteristics of this phenotype presenting as an outbreak of "mass social media-induced illness" (MSMI) and to explore predisposing factors. Between 5-9/2021, we prospectively investigated 32 patients (mean/median age: 20.1/18 years, range: 11-53 years, n = 16 females) with MSMI-FTB using a neuro-psychiatric examination, a comprehensive semi-structured interview and aspects of the Operationalized Psychodynamic Diagnostic System. In contrast to tics, numbers of complex movements and vocalizations were nine times greater than of "simple" symptoms, and of vocalizations one and a half times greater than of movements. In line with our hypothesis of MSMI, symptoms largely overlapped with those presented by German YouTuber Jan Zimmermann justifying his role as "virtual" index case in current outbreak. Typically, symptoms started abruptly at a mean age of 19 years and deteriorated gradually with no differences between males and females. In all patients, we identified timely-related psychological stressors, unconscious intrapsychic conflicts, and/or structural deficits. Nearly all patients (94%) suffered from further psychiatric symptoms including abnormalities in social behavior (81%), obsessive-compulsive behavior (OCB) (47%), Tourette syndrome (TS) (47%), anxiety (41%), and depression (31%), about half (47%) had experienced bullying, and 75% suffered from coexisting somatic diseases. Our data suggest that pre-existing abnormalities in social behavior and psychiatric symptoms (OCB, anxiety, and depression), but also TS in combination with timely-related psychological stressors, unconscious intrapsychic conflicts, and structural deficits predispose to contagion with MSMI-FTB.
Collapse
Affiliation(s)
- Carolin Fremer
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Anna Pisarenko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Martina Haas
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Luise Laudenbach
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Claudia Wegener
- Department of Audiovisual Media Studies, Film University Babelsberg, Potsdam, Germany
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| |
Collapse
|
16
|
Hull M, Parnes M. Tics and TikTok: Functional Tics Spread Through Social Media. Mov Disord Clin Pract 2021; 8:1248-1252. [PMID: 34765689 PMCID: PMC8564820 DOI: 10.1002/mdc3.13267] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Functional movement disorder is a subtype of functional neurologic symptom disorder a syndrome of involuntary physical, neurologic-type symptoms that are incongruous with "organic" disease. Throughout history, there have been outbreaks of functional symptoms in communities; until recently, spread had been confined to groups of people who shared a physical location. However, in the era of social media, a new mode of dissemination may have arisen. CASES We describe six teenage girls, each with the explosive onset of tic-like movements. Mean age of onset was 14.2 years. The presence of features incongruous with Tourette syndrome on history and examination prompted the diagnosis of functional tics. All patients reported exposure to a specific social media personality before symptom onset. CONCLUSIONS Our series suggests that social media may contribute to the spread of functional neurologic symptom disorder, in a way previously requiring physical proximity.
Collapse
Affiliation(s)
- Mariam Hull
- Pediatric Movement Disorders ClinicSection of Pediatric Neurology and Developmental NeuroscienceTexas Children's HospitalBaylor College of MedicineHoustonTexas77030USA
| | - Mered Parnes
- Pediatric Movement Disorders ClinicSection of Pediatric Neurology and Developmental NeuroscienceTexas Children's HospitalBaylor College of MedicineHoustonTexas77030USA
| |
Collapse
|
17
|
Nunziato CA, Egeland BM, Gurman A, Henry SL. Morgellons Disease: The Spread of a Mass Psychogenic Illness via the Internet and Its Implications in Hand Surgery. Hand (N Y) 2021; 16:NP5-NP9. [PMID: 33435739 PMCID: PMC8647328 DOI: 10.1177/1558944720976648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Somatic manifestations of mental illness sometimes occur in patients presenting to hand specialists. These conversion disorders can also occur in groups, a phenomenon known as "mass psychogenic illness." The increasing penetrance of the Internet and social media in modern society has greatly facilitated the interaction of patients with others with similar disorders. One example relevant to hand surgery is "Morgellons disease," a disorder popularized in 2002 and characterized by a firm belief in foreign material extruding from the skin, leading to nonhealing, self-inflicted ulcerations and excoriations. A series of 4 patients collected through an informal survey of hand surgeons regarding experience with Morgellons disease is reviewed and discussed. All patients in the series presented with a chief complaint of foreign material extruding from the hand. In 1 case, the complaint was made by a young patient's mother. In none of the patients were foreign bodies identified, although 2 patients demonstrated significant ulcerations and scars from self-excoriation. Three patients had a somatic condition affecting the hand or upper extremity, 1 directly related to self-excoriation and 2 unrelated. Treatments, workups, and ultimate outcomes varied among patients. Patients presenting with Morgellons disease often undergo multiple unnecessary tests and are at risk of inappropriate procedures. It is therefore important that providers have a compassionate understanding of the involved psychology. Herein, we offer an approach to the recognition of and treatment strategies for these patients.
Collapse
Affiliation(s)
| | | | | | - Steven L. Henry
- Dell Medical School at the University of Texas at Austin, USA,Steven L. Henry, Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Austin, TX 78712, USA.
| |
Collapse
|
18
|
Butler M, Tamborska A, Wood GK, Ellul M, Thomas RH, Galea I, Pett S, Singh B, Solomon T, Pollak TA, Michael BD, Nicholson TR. Considerations for causality assessment of neurological and neuropsychiatric complications of SARS-CoV-2 vaccines: from cerebral venous sinus thrombosis to functional neurological disorder. J Neurol Neurosurg Psychiatry 2021; 92:1144-1151. [PMID: 34362855 DOI: 10.1136/jnnp-2021-326924] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/21/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Matt Butler
- Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Arina Tamborska
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | - Greta K Wood
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | - Mark Ellul
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Rhys H Thomas
- Department of Neuroscience, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK.,Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Ian Galea
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sarah Pett
- MRC CTU at UCL, Institute for Global Health and Institute for Clinical Trials Methodology, University College London, London, UK
| | | | - Tom Solomon
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Thomas Arthur Pollak
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
| | - Benedict D Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | | |
Collapse
|
19
|
Hull M, Parnes M, Jankovic J. Increased Incidence of Functional (Psychogenic) Movement Disorders in Children and Adults Amid the COVID-19 Pandemic: A Cross-sectional Study. Neurol Clin Pract 2021; 11:e686-e690. [PMID: 34840884 PMCID: PMC8610548 DOI: 10.1212/cpj.0000000000001082] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/19/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Functional (psychogenic) movement disorders (FMDs) are conditions in which affected patients develop abnormal movements that are incongruous with known, organic, movement disorders, often associated with psychological stressors. METHODS In this case series, electronic medical records of all patients who presented to our adult and pediatric tertiary care movement disorders clinics between March 1 and October 30, 2020, and during the same period in 2019 were reviewed. All patients diagnosed with functional (psychogenic) movement disorder were included if they satisfied diagnostic criteria. RESULTS Among 550 new patients referred for evaluation at our tertiary care movement disorders centers, 45 (8.2%) received a diagnosis of FMD; 75.6% were female, in comparison to the prior year during which time 665 new patients were evaluated and 5.1% were diagnosed with FMD. This represents a 60.1% increase (90.1% in pediatric cohort, 50.9% in adult cohort) in new patients diagnosed with FMD during the COVID-19 pandemic. CONCLUSIONS Within our patient population, there has been increased incidence of FMDs in the setting of the COVID-19 pandemic, possibly reflecting increased psychological and other stressors during this period.
Collapse
Affiliation(s)
- Mariam Hull
- Section of Pediatric Neurology and Developmental Neuroscience (MH, MP), Texas Children's Hospital and Baylor College of Medicine; and Department of Neurology (MH, MP, JJ), Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX
| | - Mered Parnes
- Section of Pediatric Neurology and Developmental Neuroscience (MH, MP), Texas Children's Hospital and Baylor College of Medicine; and Department of Neurology (MH, MP, JJ), Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX
| | - Joseph Jankovic
- Section of Pediatric Neurology and Developmental Neuroscience (MH, MP), Texas Children's Hospital and Baylor College of Medicine; and Department of Neurology (MH, MP, JJ), Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX
| |
Collapse
|
20
|
Müller-Vahl KR, Pisarenko A, Jakubovski E, Fremer C. Stop that! It's not Tourette's but a new type of mass sociogenic illness. Brain 2021; 145:476-480. [PMID: 34424292 PMCID: PMC9014744 DOI: 10.1093/brain/awab316] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
We report the first outbreak of a new type of mass sociogenic illness that in contrast to all previously reported episodes is spread solely via social media. Accordingly, we suggest the more specific term ‘mass social media-induced illness’. In Germany, the current outbreak of mass social media-induced illness is initiated by a ‘virtual’ index case, who is the second most successful YouTube creator in Germany and enjoys enormous popularity among young people. Affected teenagers present with similar or identical functional ‘Tourette-like’ behaviours, which can be clearly differentiated from tics in Tourette syndrome. Functional ‘Tourette-like’ symptoms can be regarded as the ‘modern’ form of the well-known motor variant of mass sociogenic illness. Moreover, they can be viewed as the 21st century expression of a culture-bound stress reaction of our post-modern society emphasizing the uniqueness of individuals and valuing their alleged exceptionality, thus promoting attention-seeking behaviours and aggravating the permanent identity crisis of modern man. We wish to raise awareness of the current global Tourette-like mass social media-induced illness outbreak. A large number of young people across different countries are affected, with considerable impact on health care systems and society as a whole, since spread via social media is no longer restricted to specific locations such as local communities or school environments spread via social media is no longer restricted to specific locations such as schools or towns.
Collapse
Affiliation(s)
- Kirsten R Müller-Vahl
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Anna Pisarenko
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Ewgeni Jakubovski
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany
| | - Carolin Fremer
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Germany
| |
Collapse
|
21
|
Lu L, Xiong W, Mu J, Zhang Q, Zhang H, Zou L, Li W, He L, Sander JW, Zhou D. The potential neurological effect of the COVID-19 vaccines: A review. Acta Neurol Scand 2021; 144:3-12. [PMID: 33779985 PMCID: PMC8250748 DOI: 10.1111/ane.13417] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/28/2021] [Accepted: 03/06/2021] [Indexed: 02/05/2023]
Abstract
The coronavirus disease 2019 caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become a pandemic with people infected in almost all countries. The most efficient solution to end this pandemic is a safe and efficient vaccine. Classic platforms are used to develop vaccines including live‐attenuated vaccine, inactivated vaccine, protein subunit vaccine, and viral vector. Nucleic acid vaccine uses next‐generation platforms for their development. Vaccines are now rushing to the market. Eleven candidates are in advance development. These comprise inactivated vaccines, viral vector vaccine, nucleic acid vaccine, and the protein subunit vaccine platform, which are now quite advanced in trials in various geographic and ethnic populations. The reported severe adverse effects raised the worries about their safety. It becomes critical to know whether these vaccines will cause neurologic disorders like previously recognized vaccine‐related demyelinating diseases, fever‐induced seizure, and other possible deficits. We reviewed the most promising COVID‐2 vaccines with a particular interest in mechanism(s) and adverse effect(s). We exemplify potential neurological problems these vaccines could cause by looking at previous studies. The current evidence indicated a minor risk of the acute neurological disorders after the application. The observation of the long‐time effect is still needed.
Collapse
Affiliation(s)
- Lu Lu
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Weixi Xiong
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Jie Mu
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Qi Zhang
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Hesheng Zhang
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Ling Zou
- Department of Radiology West China Hospital of Sichuan UniversityThe International OfficeWest China Hospital of Sichuan University Chengdu China
| | - Weimin Li
- Department of Pulmonary & Critical Care Medicine West China Hospital of Sichuan University Chengdu China
| | - Li He
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| | - Josemir W. Sander
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
- NIHR University College London Hospitals Biomedical Research CentreUCL Queen Square Institute of Neurology London United Kingdom
- Stichting Epilepsie Instellingen Nederland (SEIN) Heemstede Netherlands
| | - Dong Zhou
- Department of Neurology West China Hospital of Sichuan University Chengdu China
- DInstitute of Brain science and Brain‐inspired technology of West China Hospital Sichuan University Chengdu China
| |
Collapse
|
22
|
Larson HJ, Sahinovic I, Balakrishnan MR, Simas C. Vaccine safety in the next decade: why we need new modes of trust building. BMJ Glob Health 2021; 6:bmjgh-2020-003908. [PMID: 34011503 PMCID: PMC8137162 DOI: 10.1136/bmjgh-2020-003908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/04/2022] Open
Abstract
Among the realm of highly varied vaccine perceptions and concerns expressed by publics around the world, vaccine safety is the most frequently cited. While many of the safety questions raised have substantial evidence to address the concerns, vaccines do have small risks, and need vigilant and responsive systems to address them. With more and more new vaccines, combinations of vaccines and new technologies to develop and deliver them, new safety concerns will arise that need attention. Adding to this landscape is the dramatic impact which digital communication has had on how fast rumours and vaccine concerns can spread, making the task of the public health and scientific community even more pressing. One of the more recently characterised vaccine safety issues, now named 'immunisation stress-related-response,' has gained particularly high visibility given these highly globally connected social media networks. To better anticipate and address these rapidly shared vaccine safety concerns, a number of global efforts and local responses are being made. Co-created social media campaigns engaging parents and adolescents have been effective, while the WHO's Vaccine Safety Net (VSN) initiative has grown its global network to increase awareness about vaccines and contribute to building confidence in vaccines. The VSN reviews websites around the world to assess their quality and accuracy to ensure and promote access to trustworthy and science-based information on vaccine safety for internet users. These and the efforts of the multiple network partners are more crucial than ever to sustain public confidence in this evolving vaccine safety landscape.
Collapse
Affiliation(s)
- Heidi J Larson
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Clarissa Simas
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
23
|
Affiliation(s)
- Kate Faasse
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
24
|
Marchetti RL, Gallucci-Neto J, Kurcgant D, Proença ICGF, Valiengo LDCL, Fiore LA, Pinto LF, Maranhão AGK, Oliveira MTDC, de Oliveira LH. Immunization stress-related responses presenting as psychogenic non-epileptic seizures following HPV vaccination in Rio Branco, Brazil. Vaccine 2020; 38:6714-6720. [PMID: 32878709 DOI: 10.1016/j.vaccine.2020.08.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022]
Abstract
IMPORTANCE The absence of a positive diagnosis of psychogenic non-epileptic seizures (PNES) in immunization stress-related response (ISRR) clusters may have not only a direct impact on affected patients' health but may also reduce compliance to national vaccination programs. It is therefore crucial to develop efficient diagnostic tools and a feasible proposal for proper communication and treatment of ISRR. PURPOSE To explore the psychogenic nature of patients' convulsive seizures in a suspected outbreak of an ISRR cluster following human papillomavirus vaccination in Rio Branco, Brazil. METHODS Twelve patients with convulsive seizures were submitted to prolonged intensive video-electroencephalography monitoring, brain magnetic resonance imaging, cerebrospinal fluid diagnostic testing, laboratory subsidiary examinations, and complete neurological and psychiatric evaluations. RESULTS Ten patients received the positive diagnosis of PNES, and two patients received the diagnosis of idiopathic generalized epilepsy. No biological association was found between the HPV vaccine and the clinical problems presented by the patients. CONCLUSIONS Prolonged VEEG monitoring can contribute significantly to the positive diagnosis of PNES in ISRR clusters and to avoid hesitancy to vaccinate.
Collapse
Affiliation(s)
- Renato Luiz Marchetti
- Neuropsychiatry Program, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil.
| | - Jose Gallucci-Neto
- Neuropsychiatry Program, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil; VEEG Unit, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Daniela Kurcgant
- Neuropsychiatry Program, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Inah Carolina Galatro Faria Proença
- Neuropsychiatry Program, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Leandro da Costa Lane Valiengo
- Neuropsychiatry Program, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Lia Arno Fiore
- VEEG Unit, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Lécio Figueira Pinto
- VEEG Unit, Department and Institute of Psychiatry, University of São Paulo Faculty of Medicine, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP CEP 05403-903, Brazil
| | - Ana Goretti Kalume Maranhão
- National Immunization Program, Health Surveillance Secretariat, Brazilian Ministry of Health, SRTVN, Quadra 701, Lote 3, Edifício PO 700, 6° andar, CGPNI, Asa Norte, Brasília, DF CEP: 70.719-040, Brazil.
| | - Maria Tereza da Costa Oliveira
- Immunization Unit/Family, Health Promotion and Life Course, Pan American Health Organization, 525 Twenty-third Street, NW Washington DC, USA.
| | - Lucia Helena de Oliveira
- Immunization Unit/Family, Health Promotion and Life Course, Pan American Health Organization, 525 Twenty-third Street, NW Washington DC, USA.
| |
Collapse
|
25
|
Mass Psychogenic Illness in Haraza Elementary School, Erop District, Tigray, Northern Ethiopia: Investigation to the Nature of an Episode. PSYCHIATRY JOURNAL 2020; 2020:2693830. [PMID: 32775400 PMCID: PMC7396040 DOI: 10.1155/2020/2693830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022]
Abstract
Background Mass psychogenic illness has been documented for more than 600 years in a variety of cultural, ethnic, and religious settings. We aimed to assess the nature and characteristics of mass psychogenic illness and to evaluate community awareness and perception about the treatment they practiced in Haraza Elementary School, Erop district, Tigray, Northern Ethiopia. Methods A school-based cross-sectional study was conducted in Haraza Elementary School from January to February, 2020. Students who were victims of an episode were subjects of the study. A total of twelve students were investigated using a semistructured questionnaire for a quantitative study. Seven key informant interviews were conducted using a guiding questionnaire. Quantitative data was analyzed using XL sheet while qualitative data were analyzed manually. Results The mean age of study participants was 14 years (SD ± 1.3). The majority (87%) were teenage female students. The incident was an unspecified disease with psychiatric disorder, migraine, and syncope with no plausible organic causes. An important feature of migraine and syncope was their comorbidity with mass psychogenic illness. The community perceived that evil devil force and blaming the being as an evil eye were common causes of the occurrence of an episode. Conclusion Lack of empirical knowledge and awareness about its management and prevention among community members and health professionals resulted exaggerated rumor that would perceive as newly emerging disease that affected school activities. Integrating MPI in PHEM package at health facility level, advocacy workshops for media, and other relevant stakeholders will minimize its impact for the future.
Collapse
|
26
|
Chentsova‐Dutton YE, Ryder AG. Cultural models of normalcy and deviancy. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/ajsp.12413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Andrew G. Ryder
- Concordia University Montreal Quebec Canada
- Jewish General Hospital Montreal Quebec Canada
| |
Collapse
|
27
|
Simas C, Munoz N, Arregoces L, Larson HJ. HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia. Hum Vaccin Immunother 2018; 15:163-166. [PMID: 30118381 PMCID: PMC6363158 DOI: 10.1080/21645515.2018.1511667] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
We report the case of multiple adverse reactions following HPV vaccination in Colombian adolescents in Carmen de Bolivar. In August 2012, the country introduced a school-based HPV immunization programme which successfully reached over 90% of the target population in the first year. In 2014, between May 29th and June 2nd,15 adolescent girls in one school presented adverse reactions after vaccination and were admitted to the local hospital. Soon, videos of girls fainting, twitching, and arriving unconscious at emergency rooms started to appear in national news media as well as on social media platforms such as YouTube. The viral spread of these videos and disturbing images were followed by the viral spread of symptoms, with over 600 cases reported across Colombia. Thorough epidemiological investigation by Colombian health authorities found no organic association between the teenagers' symptoms and the HPV vaccine, concluding this was a case of mass psychogenic reaction to vaccination. Scientific evidence did not appease the anxious public whose confidence in HPV immunization dropped dramatically. By 2016, HPV vaccine uptake among eligible girls declined to 14% for the first dose and 5% for the complete course, down from 98% and 88%, respectively, in 2012. We document this case and discuss the role of news and social media, particularly YouTube, as a driver of contagious psychogenic reactions. We also discuss the role of health authorities and government, and the importance of acting rapidly and appropriately to contain the spread of such symptoms and maintain public confidence in vaccines.
Collapse
Affiliation(s)
- Clarissa Simas
- a London School of Hygiene and Tropical Medicine , London , UK
| | - Nubia Munoz
- b Emeritus Professor at the Cancer Institute of Colombia , International Epidemiological Association , Colombia
| | | | - Heidi J Larson
- a London School of Hygiene and Tropical Medicine , London , UK
| |
Collapse
|
28
|
Ayehu M, Endriyas M, Mekonnen E, Shiferaw M, Misganaw T. Chronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based cross-sectional study. Int J Ment Health Syst 2018; 12:31. [PMID: 29930699 PMCID: PMC5992694 DOI: 10.1186/s13033-018-0207-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outbreaks of mass psychogenic illness (MPI), which are a constellation of physical signs and symptoms suggestive of organic illness with no identifiable causes. MPI has been documented in numerous cultural, ethnic, and religious groups throughout the world. The aims of this study were to document the nature and impacts of the illness, to assess interventions, and to come up with recommendations and management formulations for dealing with such kinds of outbreaks in the future. METHODS Community based cross-sectional study was conducted in June, 2015 in Derashe Woreda, Segen Area People Zone of the Southern Nations Nationalities and People's Region. Women with complaints of breast cancer but with no objective findings were the subjects of the study. Ninety-seven women were investigated using a semi-structured questionnaire for quantitative study. Two focus group discussions with seven affected and seven non-affected women and four key informant interviews were conducted using guiding questionnaires. Quantitative data was analyzed using SPSS version 20 software packages while qualitative data was analyzed manually going through thematic areas. RESULT The ages of the ninety-seven study participants ranged from 17 to 56 years, with a mean (SD) of 32.8 (8.7) years. Onset of illness was dated back to the year 2012 following the death of a 43 year old socially active woman with complications of breast cancer. Following her death many women started to report multiple vague physical complaints similar to those of the deceased woman. Even though the responses from the study participants did not specifically point to a single possible cause and means of transmission, high numbers of women believed the source of their illness could be punishment from God while some said that the cause of their suffering could be environmental pollution. Since the illness was taken to be contagious, affected women faced stigma and discrimination. Moreover, school activities and social gatherings were limited significantly. CONCLUSION Unrealistic and exaggerated rumors and inadequate explanations about the nature and spread of the illness were the main contributing factors for the spread and prolongation of the outbreak. An organized intervention, clear and adequate explanations about the nature and transmission of the illness can contain MPI within a short period of time.
Collapse
Affiliation(s)
- Moges Ayehu
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | | | | | | | | |
Collapse
|
29
|
Faasse K, Yeom B, Parkes B, Kearney J, Petrie KJ. The Influence of Social Modeling, Gender, and Empathy on Treatment Side Effects. Ann Behav Med 2018; 52:560-570. [DOI: 10.1093/abm/kax025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
Background
Social modeling has the capacity to shape treatment outcomes, including side effects.
Purpose
This study investigated the influence of social modeling of treatment side effects, gender, and participant empathy, on side effects of a placebo treatment.
Methods
Ninety-six participants (48 females) completed a study purportedly investigating the influence of modafinil (actually placebo) on alertness and fatigue. The participants were randomly seated with a male or female confederate and saw this confederate report experiencing side effects or no side effects. Participant empathy was assessed at baseline. Changes in modeled and general symptoms, and misattribution of symptoms, were assessed during the session and at 24-hr follow-up.
Results
During the experimental session, seeing side effect modeling significantly increased modeled symptoms (p = .023, d = 0.56) but not general or misattributed symptoms. Regardless of modeling condition, female participants seated with a female model reported significantly more general symptoms during the session. However, response to social modeling did not differ significantly by model or participant gender. At follow-up, the effect of social modeling of side effects had generalized to other symptoms, resulting in significantly higher rates of modeled symptoms (p = .023, d = 0.48), general symptoms (p = .013, d = 0.49), and misattributed symptoms (p = .022, d = 0.50). The experience of modeled symptoms in response to social modeling was predicted by participants’ levels of baseline empathy.
Conclusions
Social modeling of symptoms can increase the side effects following treatment, and this effect appears to generalize to a broader range of symptoms and symptom misattribution over time. Higher baseline empathy seems to increase response to social modeling.
Collapse
Affiliation(s)
- Kate Faasse
- The University of Auckland, Department of Psychological Medicine, Auckland, New Zealand
- The University of New South Wales, School of Psychology, Sydney, Australia
| | - Brian Yeom
- The University of Auckland, School of Medicine, Auckland, New Zealand
| | - Bryony Parkes
- The University of Auckland, Department of Psychological Medicine, Auckland, New Zealand
| | - James Kearney
- The University of Auckland, School of Medicine, Auckland, New Zealand
| | - Keith J Petrie
- The University of Auckland, Department of Psychological Medicine, Auckland, New Zealand
| |
Collapse
|
30
|
Faasse K, Porsius JT, Faasse J, Martin LR. Bad news: The influence of news coverage and Google searches on Gardasil adverse event reporting. Vaccine 2017; 35:6872-6878. [PMID: 29128382 DOI: 10.1016/j.vaccine.2017.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/01/2017] [Accepted: 10/03/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human papilloma virus vaccines are a safe and effective tool for reducing HPV infections that can cause cervical cancer. However, uptake of these vaccines has been suboptimal, with many people holding negative beliefs and misconceptions. Such beliefs have been linked with the experience of unpleasant side effects following medical treatment, and media coverage may heighten such concerns. METHODS The present study sought to assess the influence of news coverage (number of news articles per month) on adverse event reporting in response to Gardasil vaccination in New Zealand over a 7.5-year period, and whether the influence of news coverage was mediated by internet search activity (Google search volumes). Multiple linear regression analyses and simple mediation analyses were used, controlling for year and number of vaccinations delivered. RESULTS News coverage in the previous month, and Google search volumes in the same month, were significant predictors of adverse event reporting, after accounting for vaccination rates and year. Concurrent Google search volumes partially mediated the effect of prior news coverage. CONCLUSION The results suggest that some of the adverse events reported were not related to the vaccination itself, but to news coverage and internet search volumes, which may have contributed to public concerns about potentially unpleasant or harmful outcomes. These findings have implications for the importance of psychological and social factors in adverse event reporting, and the role of the news media in disseminating health information.
Collapse
Affiliation(s)
- Kate Faasse
- School of Psychology, UNSW Sydney, Sydney, Australia.
| | - Jarry T Porsius
- Faculty of Design Engineering, Delft University of Technology, Delft, The Netherlands; Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Plastic and Reconstructive Surgery, Erasmus MC, Rotterdam, The Netherlands
| | | | - Leslie R Martin
- Psychology and Neuroscience, La Sierra University, Riverside, CA, USA
| |
Collapse
|
31
|
Rius C, Baselga E, Tizón J, Fuentes P, Muñoz-Garza FZ, Roigé G, Llebaria X, Caylà JA. Investigación de una sospecha de brote de lipoatrofia semicircular en niños. Med Clin (Barc) 2017; 149:101-106. [DOI: 10.1016/j.medcli.2017.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 12/30/2016] [Accepted: 01/12/2017] [Indexed: 11/16/2022]
|
32
|
Abstract
This paper reports an ethnographic study of mass fainting among garment factory workers in Cambodia. Research was undertaken in 2010-2015 in 48 factories in Phnom Penh and 8 provinces. Data were collected in Khmer using nonprobability sampling. In participant observation with monks, factory managers, health workers, and affected women, cultural understandings were explored. One or more episodes of mass fainting occurred at 34 factories, of which 9 were triggered by spirit possession. Informants viewed the causes in the domains of ill-health/toxins and supernatural activities. These included "haunting" ghosts at factory sites in the wake of Khmer Rouge atrocities or recent fatal accidents and retaliating guardian spirits at sites violated by foreign owners. Prefigurative dreams, industrial accidents, or possession of a coworker heralded the episodes. Workers witnessing a coworker fainting felt afraid and fainted. When taken to clinics, some showed signs of continued spirit influence. Afterwards, monks performed ritual ceremonies to appease spirits, extinguish bonds with ghosts, and prevent recurrence. Decoded through its cultural motifs of fear and protest, contagion, forebodings, the bloody Khmer Rouge legacy, and trespass, mass fainting in Cambodia becomes less enigmatic.
Collapse
|
33
|
Faasse K, Perera A, Loveys K, Grey A, Petrie KJ. Enhancing treatment effectiveness through social modelling: A pilot study. Psychol Health 2017; 32:626-637. [PMID: 28276743 DOI: 10.1080/08870446.2017.1293056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Medical treatments take place in social contexts; however, little research has investigated how social modelling might influence treatment outcomes. This experimental pilot study investigated social modelling of treatment effectiveness and placebo treatment outcomes. DESIGN Fifty-nine participants took part in the study, ostensibly examining the use of beta-blockers (actually placebos) for examination anxiety. Participants were randomly assigned to observe a female confederate report positive treatment effects (reduced heart rate, relaxed, calm) or feeling no different. MAIN OUTCOME MEASURES Heart rate, anxiety and blood pressure were assessed, as were symptoms and attributed side effects. RESULTS Heart rate decreased significantly more in the social modelling compared to control condition, p = .027 (d = .63), and there were trends towards effects in the same direction for both anxiety, p = .097 (d = .46), and systolic blood pressure, p = .077 (d = .51). Significant pre-post placebo differences in heart rate, anxiety and diastolic blood pressure were found in the social modelling group, ps < .007 (ds = .77-1.37), but not the control condition, ps > .28 (ds = .09-.59). CONCLUSIONS Social observation of medication effectiveness enhanced placebo effectiveness in heart rate, and showed a trend towards enhancing treatment effectiveness in both anxiety and systolic blood pressure. Social modelling may have utility in enhancing the effectiveness of many active medical treatments.
Collapse
Affiliation(s)
- Kate Faasse
- a School of Psychology , University of New South Wales , Sydney , Australia.,b Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand
| | - Anna Perera
- b Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand
| | - Kate Loveys
- b Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand
| | - Andrew Grey
- c Department of Medicine , The University of Auckland , Auckland , New Zealand
| | - Keith J Petrie
- b Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand
| |
Collapse
|
34
|
Jacobsen P, Ebbehøj NE. Reply to Jansen et al. J Emerg Med 2016; 52:581-583. [PMID: 27998632 DOI: 10.1016/j.jemermed.2016.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Peter Jacobsen
- Department of Environmental and Occupational Medicine, Danish Poison Centre, Copenhagen University, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - Niels Erik Ebbehøj
- Department of Environmental and Occupational Medicine, Danish Poison Centre, Copenhagen University, Bispebjerg Hospital, Copenhagen NV, Denmark
| |
Collapse
|
35
|
Abstract
The social context in which people take medicines can strongly influence the drug response in both positive and negative ways. We first examine the role of social modeling in influencing treatment outcomes through modifying placebo and nocebo responses, and then explore possible mechanisms for these effects. Viewing another person show improvement after taking a drug can increase the placebo component of the medicine and thus the overall potency of the treatment. Likewise, seeing another person who has taken the same medicine report side effects can substantially increase adverse effects. Such effects can also occur on a wider scale following changes in medicine formulations or from vaccinations programs, when the media transmit adverse effects from these treatments to a wider audience. Females seem to be more susceptible than males to the social modeling of adverse effects of treatments. A greater awareness of the effects of social modeling has potential to improve the effectiveness of medical treatments, minimize side-effect burden, and also lead to more effective management of health scares.
Collapse
Affiliation(s)
- Kate Faasse
- School of Psychology, University of New South Wales
| | - Keith J. Petrie
- Department of Psychological Medicine, University of Auckland
| |
Collapse
|
36
|
Jacobsen P, Ebbehøj NE. Outbreak of Mysterious Illness Among Hospital Staff: Poisoning or Iatrogenic Reinforced Mass Psychogenic Illness? J Emerg Med 2015; 50:e47-52. [PMID: 26553502 DOI: 10.1016/j.jemermed.2015.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/05/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT Four of seven staff members in an emergency department became acutely ill with nonspecific symptoms. After uneventful observation they were discharged, but symptoms worsened at reassembly for debriefing. Poisoning with hydrogen sulfide was suspected, and the victims were transferred by helicopter for hyperbaric oxygen (HBO) treatment. During the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged sick leave. The ward was closed for several weeks during comprehensive but negative investigations for toxic chemicals. Clinical data and lack of indication of chemical exposure, together with an attack pattern with only some individuals becoming ill in a shared environment, suggest MPI. Iatrogenic influence from dramatic intervention was probably a strong driving force in the outbreak. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Awareness of MPI may prevent unnecessary and potentially harmful treatment as well as improve health care resilience, particularly with respect to preparedness. Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention.
Collapse
Affiliation(s)
- Peter Jacobsen
- Department of Occupational and Environmental Medicine and Danish Poison Information Centre, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - Niels Erik Ebbehøj
- Department of Occupational and Environmental Medicine and Danish Poison Information Centre, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
37
|
GOLDSTEIN DONNAM, HALL KIRA. Mass hysteria in Le Roy, New York: How brain experts materialized truth and outscienced environmental inquiry. AMERICAN ETHNOLOGIST 2015. [DOI: 10.1111/amet.12161] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- DONNA M. GOLDSTEIN
- Department of Anthropology; University of Colorado Boulder; Hale Building, Campus Box 233 Boulder CO 80309-0233
| | - KIRA HALL
- Department of Linguistics; University of Colorado Boulder; Hellems 290, 295 UCB Boulder CO 80309-0295
| |
Collapse
|
38
|
Crichton F, Petrie KJ. Accentuate the positive: Counteracting psychogenic responses to media health messages in the age of the Internet. J Psychosom Res 2015; 79:185-9. [PMID: 25963037 DOI: 10.1016/j.jpsychores.2015.04.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 04/23/2015] [Accepted: 04/25/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The Internet has expanded the scope for creating health scares and increased the risk of nocebo responding in individuals exposed to misinformation about threats to personal health posed by aspects of modern life, such as exposure to new technologies. It was the aim of this experiment to investigate whether the delivery of positive expectations might reduce or reverse symptoms triggered by negative expectations formed from such misinformation. METHOD In the context of a study investigating symptoms during exposure to windfarm sound, 64 volunteers assessed their symptomatic experiences during two discrete sessions, throughout which they listened to wind turbine sound containing audible and sub-audible (infrasound) components. Participants were randomly assigned to watch either positive or negative information about the health effects of infrasound prior to their first infrasound exposure session. They were then shown the alternate information and exposed to infrasound during their second session. RESULTS Participants receiving negative expectations were less symptomatic during exposure if they had previously received positive expectations about infrasound. Further, participants given positive expectations after the earlier delivery of negative expectations exhibited a placebo response, reversing the nocebo response exhibited in their first exposure session. CONCLUSION Results suggest accessing positively framed health information may reverse or dilute the effect of negative expectations formed from exposure to media warnings about health risks posed by new technologies, such as wind turbines.
Collapse
|
39
|
Mascia A, Quarato PP, D'Aniello A, Di Gennaro G. Psychogenic nonepileptic seizures mimicking gelastic seizures: A description of two cases. EPILEPSY & BEHAVIOR CASE REPORTS 2015; 4:67-9. [PMID: 27195218 PMCID: PMC4543217 DOI: 10.1016/j.ebcr.2015.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 11/30/2022]
Abstract
Psychogenic nonepileptic seizures (PNES) are sudden, involuntary seizure-like attacks that, unlike epileptic seizures, are not related to electrographic ictal discharges and are psychological in nature. Psychogenic nonepileptic seizures presenting symptoms mimic a wide array of nervous system dysfunctions, as they involve changes in behavior, motor activity, sensation, cognitive, and autonomic functions. Spontaneous paroxysms of laughing resembling gelastic seizure have only exceptionally been reported as main symptom of PNES. Here, we describe the cases of two patients with a prolonged history of laughter attacks mistaken for epilepsy and unresponsive to AED treatment. Brain MRI and interictal EEG were unremarkable. Video-EEG monitoring allowed us to document the spontaneous and suggestion-induced habitual episodes that were then diagnosed as PNES.
Collapse
|
40
|
Palacios R. Considerations on immunization anxiety-related reactions in clusters. Colomb Med (Cali) 2014; 45:136-40. [PMID: 25386041 PMCID: PMC4225792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 09/25/2014] [Accepted: 09/29/2014] [Indexed: 11/06/2022] Open
Abstract
A cluster of adverse events following immunization (AEFI) represents a stress test for an immunization program. The community can suspect on vaccine-related reaction leading to mistrust on the immunization program. An immunization anxiety-related reaction is one of the hypotheses to be tested and can be reasonably accepted when the vaccine-related and immunization error-related reactions are ruled out and no coincidental events can explain the cases. Immunization program approaches widely accepted to understand and respond to adverse events are root-cause analysis and systems analysis. Psychiatric cognitive frame will support the root-cause analysis assigning a causal relationship to individual temporary disorders of the affected vaccinees. Communication will focus on vaccine safety and absence of errors in the immunization program. Systems analysis addresses the whole context considering the fear spread as a systemic threat. Socio-psychological frame offers a broader opportunity to understand and respond to a specific community. Management is based on communication to change community belief in misperceptions of vaccine risks and support the idea of immunization as a causal factor, different from the vaccine. Communities can consider use of psychiatric labels, Mass Psychogenic Illness or Mass Hysteria, as an act of inconsiderateness. Labels like immunization anxiety-related reactions in clusters or collective immunization anxiety-related reactions are recommended to bridge the causal perception of the community with the result of the scientific investigation of the cases.
Collapse
|