[Mass-hysteria with Koro-symptoms in Thailand].

Koro, a psychogenic anxiety syndrome interfering with genital body image and sexual functioning, has hitherto been described as occurring mainly in isolated cases of South Chinese males. The present communication reports an epidemic outbreak in November 1976 in Northeastern Thailand where within a few days at least 200 patients, most of them Thai and two-thirds males, were treated at local hospitals. Main presenting symptoms were acute anxiety, in some cases leading to fainting, (subjective) shrinking of the penis and impotency in men, shrinking and/or itching of the external genitals and frigidity in women; further complaints included initial nausea and dizziness, abdominal pains, headaches, facial numbness. All patients recovered after brief symptomatic intervention. Popular opinion and news media echoed the patients' paranoid projection of viewing the epidemic as caused by Vietnamese food and tobacco poisoning in a hideous assault against the sexual vitality and general health of the Thai people, in the context of a specific socio-cultural and politico-historical situation. It appears that an adequate interpretation of Koro and of analogous hysterical symptom formation would have to go beyond the hitherto applied psychoanalytic models by considering the specific sociodynamic factors involved in the pathogenesis of such phenomena.