Culture-Specific Psychiatric Syndromes: A Review (part 4)

Zar

MELAPUS.COM
Sep 5, 2018 · 4 min read

Zar is a psychiatric illness diagnosed in North Africa and the Middle East. Attributed to spirit possession — and not considered a pathology locally — people experiencing zar undergo dissociative episodes, including fits of excessive laughing, yelling, crying, and hitting their head against a wall. Patients are often apathetic and report developing long-term relationships with their possessor.[1] On the basis of its phenomenology, zar could be conceptualized as a recurrent brief psychotic episode, delusional disorder, dissociative condition, or potentially a substance-induced event. Zar is an important example of how certain culture-bound syndromes can be seen as normal or as a sign of being “selected,” whereas other cultures would consider such symptoms pathologic.[1]

Shin-byung (Spirit Sickness)

Shin-byung is a folk diagnosis in Korea that is characterized by anxiety and numerous somatic symptoms, such as weakness, dizziness, and gastrointestinal symptoms. Patients often dissociate and attribute their state to possession by ancestral spirits.[1] The condition can also be viewed as somatization of an underlying major depressive or anxiety disorder, or as an adjustment disorder, which is destigmatized by attributing this mental state to possession by a spirit. Shin-byung shares features of somatoform or dissociative disorders.

Ghost Sickness

Ghost sickness is characterized by a preoccupation with death and the deceased and is frequently seen in Native Americans but has also been described in Hispanic cultures. Symptoms are broad and can include weakness, dizziness, loss of appetite, feelings of danger, dizziness, fear, anxiety, hallucinations, and a sense of suffocation.[1] As evidenced by this symptom constellation, ghost sickness could also be conceptualized as protracted or pathological grief or depression, which is expressed predominantly somatically and may increase the acceptability of the disturbed mental state to afflicted people and those who know them.

Susto

From the Spanish word for “fright,” susto refers to the soul leaving the body in response to a frightening experience. Susto is diagnosed in certain Latino populations. Symptoms can recur for years and are consistent with multiple DSM-5 diagnoses, including major depressive disorder, posttraumatic stress disorder, and somatic symptom and related disorders.[1]

Falling Out

Falling-out episodes are characterized by a sudden collapse, sometimes preceded by dizziness, in which patients often report temporary blindness despite their eyes remaining open. Falling out is found in the southern United States and the Caribbean. Patients are generally aware of their environment but report being unable to move.[1] This set of symptoms has overlapping features with cataplexy, a rare condition in which patients have a sudden and transient loss of muscle tone (usually in response to strong emotions) and fall to the ground. They also may experience vasovagal syncope due to a strong physical or psychological event, as well as catatonia, conversion disorder, or dissociative disorder.

Grisi Siknis

Grisi siknis is a hysterical condition reported in Nicaragua. In English, the term translates to “crazy sickness.” It is highly contagious and affects mainly young girls and women, especially those 15–18 years old. The attacks start with headaches, dizziness, anxiety, nausea, irrational anger, and/or fear. During the attack, the victim “loses consciousness,” falls to the ground, and subsequently runs away. Afflicted persons may view others as devils, feel no pain from bodily injuries, and have absolute amnesia regarding their physical circumstances. Some shadow-fight with unseen opponents, whereas others have been reported to have performed superhuman acts and spoken in tongues. This condition has features of dissociative or conversion disorders.[1]

Gururumba

Gururumba is a diagnosis from New Guinea that describes an episode in which the afflicted person (usually a married man) begins burglarizing neighboring homes, taking objects that he considers valuable but which seldom are. He then runs away, often for days, returning without the objects and amnestic about the episode. Sufferers have been described as hyperactive, clumsy, and with slurred speech. This syndrome has features of a dissociative or conversion disorder but also could be a substance intoxication-related condition.[8]

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Η πρώτη πλατφόρμα για την Ψυχική υγεία.

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