The Nature of Koro: A Culture-Bound Disorder

The Nature of Koro: A Culture-Bound Disorder
Culture-bound syndromes (CBSs) comprise a diverse set of illness phenomena that the DSM-IV defines as
recurrent, locality-specific patterns of aberrant behavior and troubling experience that may or may not be linked to a particular DSM-IV diagnostic category. Many of these patterns of behavior are indigenously considered to be'illnesses', or at least afflictions, and most have local names.
Koro is one such culture-specific psychiatric disorder occurring primarily in southeast Asia whose main feature is acute anxiety attributed to the fear of genital retraction. People with Koro syndrome, usually men, believe that complete disappearance of the genital organ will result in death (Kovacs & Osvath, 1998). A typical episode will occur when a man goes to urinate in the cold or when emotionally upset (often due to guilt over masturbation or frequenting prostitutes, while concerned about his sexual performance, or after a fight with his wife). The individual may attempt to grasp his genitals in order to prevent them from retracting or use mechanical devices such as cords, chopsticks, clamps, or small weights. (Rosca-Rebaudengo et al, 1996). The clinical description is characterized by three phases:
a prodromal [phase, a] penile shrinking phase…and a recovery phase. The prodromal phase include[s] somatic symptoms such as vertigo, genital pain or numbness, and diarrhea…[t]he penile shrinking phase [is] marked by…genital numbness…discomfort on urination, accompanied by panic reactions…[and] the recovery phase [includes] fears of continuing impotence [and] genital shrinkage. (Suwanlert & Coates, 1977)
Episodes may strike the same individual repeatedly, and epidemics have been noted, most famously the great Koro epidemic in Singapore in 1967 (Cheng, 1997).
The credit for the veryfirst report of Koro in a Western medical journal goes to Dr. J.C. Blonk in 1895 (Cho…

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