Classical Koro and Koro-Like Symptoms: Illustration from Canada

Koro syndrome has been colorfully described as a pathological distortion of one’s body image of the genital organ. In Koro, body image dysphoria is characterized by severe anxiety related to the delusional idea that one’s genitals will shrink and retract into one’s abdomen, eventually leading to death. This syndrome was first reported in South East Asia, where endemics have been described, but it has also sporadically occurred globally. We present a systematic literature review on Koro syndrome and report 7 cases from Canada. A search review with PubMed and Google Scholar resulted in 504 entries. Sixty-seven manuscripts were eventually selected following a thorough elimination process. The resultant literature underscored the cultural diversity that underlay the reported cases. Various aspects of Koro have been examined (eg, etiological, clinical, diagnostic, and cultural aspects). It has stimulated substantial scholarly debate, discussions, correspondences, and arguments from anthropological, psychiatric, psychological, and biological perspectives. In our series, it seems that Koro could have been misattributed here. The primary concern was not with penile retraction of the cases. To our knowledge, this is the first time that a series of cases is documented from North America where the syndrome is often ignored. We highlight the potential differences between the classical Koro syndrome and a collection of beliefs related to the perception or delusion of penile retraction in other codable psychiatric disorders, Koro-like syndrome. Understanding Koro syndrome beyond geographic boundaries is in line with our collected case reports of Koro from outside Asia.

The Socio-Cultural and Confessional Dimension of Delusional Ideas Content in the Spectrum of Non-Organic Psychotic Disorders

In the last decade, population clinical trials support the disabling nature of most globally diagnosed psychotic disorders. As a defining integral part of this pathology, the delusional idea considered to be the result of the inaccurate and abnormal interpretation of an external reality is individualized, despite the contrary evidence. This ideation’s clinical expression variability is influenced by a heterogeneous spectrum of biological and psychosocial factors, predisposing and/or favouring. This review’s main objective is to identify a series of relational patterns of the content of delusional ideation with socio-familial and cultural/confessional parameters to obtain a holistic approach to patients. Careful decipherment of these conditions can be the basis for developing new interventions that are much more effective in establishing a long-term diagnostic and therapeutic strategy.

Self-mutilation in urologic patients: Case report

Self-mutilation is intentionally injuring oneself. Generally, the most common self-inflicted wounds are burns and cuts which can be closed and open. In extreme cases it could be a suicidal attempt. In urology, genitals are usually the object of mutilation. Because of their anatomical features and topographic location, they are most commonly exposed to these procedures. There may be cuts on the penis, perineum, scrotum; scrotum avulsion, orhiectomia, castration to penile amputation. These are mental patients suffering from paranioid schizophrenia. As part of their delusions, they have bodily-cinesthetic hallucinations that manifest discomfort in the genital area. There is a delusional idea that the only solution to eliminate the hallucinations present is to self-mutilate. Because these organs are very blood-borne, they are always shocked after the ritual because of bleeding and pain. We present a 46-year-old patient with severe genital injury, scrotum avulsion, and subtotal penile amputation. Since more than 2 hours had passed since self-mutilation, the suture of the penis could not be done, so after resuscitation, a suture of the scrotum, tunica albuginae and an external urethral opening were done. After leaving the recovery room, he was transferred to a psychiatric ward and later to a higher health care facility.

Alcohol consumption in 2049 patients with paranoia

IntroductionEpidemiological studies have reported associations between alcohol consumption or abuse and occurrence of delusional disorder (F.22) rather than in general population. Alcohol has not been described as the main cause of the delusional idea, but is an enhancer factor which would inhibit behavioral brake and executive function in prefrontal cortex facilitating the development of the existing delusional idea.HypothesisWe want to confirm this association in our influence area so this study aims to report compared frequency of alcoholism in DD versus a control group published in andalusian population.AimsTo review the literature on the potential links between alcohol abuse and delusional disorder and this relationship in general population.ResultsThis poster presents a brief but updated systematic literature review on the associations between DD and alcohol abuse. We will also present data from a relatively large case-mix of 2049 patients with the diagnosis of delusional disorder resulting from a thorough retrospective, medical-record based, assessment of patients attended in our clinical catchment area.In our sample, alcohol abuse and other drugs consumption was significantly less common in Delusional Disorder than in other psychoses.This result suggests that alcohol and other drugs consumption can be a greater importance parameter in other psychoses correlates than in delusional disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.