Koro: proposed classification for DSM-IV

Article Abstract:

Koro is a psychiatric disorder that has been recognized for centuries in Asian cultures, but only came to the attention of Western science in 1895. The diagnosis of many cases has led to the proposed classification of this disorder for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Koro is characterized by the patient's belief that his genitals are retracting or shrinking into his body, and that the disappearance of the genital organ, which the patient feels is imminent, will cause his death. Although this mental disorder had been predominantly observed among Asian men, cases have been reported among Indians and others who have not had any exposure to Asian culture. The Western psychoanalytic perception of koro has considered the condition to be an example of extreme castration fear. Koro has also been viewed as a hypochondriacal delusion which accompanies depression. An appendix to this article proposes a description of koro that includes associated features, age at onset, course, complications, prevalence, predisposing factors, and other features. The condition primarily affects men of low educational levels who also have ambivalent feelings towards their sexuality. Another associated feature reported with some cases of koro is the appearance of ghosts without penises who want to steal the penises of the living. The condition has been reported to be epidemic in some regions, but single cases have also been reported. It is proposed that inclusion of koro in the DSM-IV is necessary, and that this disorder may serve as a model for other culturally based mental disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Causes of, Fear of death, Penis

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Interpersonal relatedness and paranoid schizophrenia

Article Abstract:

A case is examined of a 33-year-old African American Army veteran who has carried the diagnosis of chronic paranoid schizophrenia since he was 23 and who has a delusional companion named Max. The case is interesting because, although the patient displays Schneiderian symptoms and appears to fit the profile of someone with paranoid schizophrenia, he does not manifest the classic Bleulerian symptoms of autism. He is found to respond immediately to neuroleptic and shows himself to be easily engageable. It is argued that it is not appropriate to label the patient schizophrenic.

Mentally ill persons, Diagnosis, Mentally ill, Interpersonal relations, Paranoid schizophrenia

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Koro in an immigrant from Guinea with brief psychotic disorder

Article Abstract:

Koro was reported in a 41-year-old immigrant from Guinea who fulfilled diagnostic criteria for brief psychotic disorder. The patient was hospitalized after he tried to kidnap a nursing home resident whom he believed to be his father. Psychiatric evaluation showed that the patient had ideas of reference, thought broadcasting and intense anxiety from the belief that his penis was receding into his body. The patient's psychotic symptoms were resolved following a 10-day course of haloperidol.

Letter to the Editor, Psychoses, Psychotic disorders, Koro syndrome

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