Koro, also known as shrinking penis syndrome, is a culture-bound syndrome characterized by intense fear and anxiety attacks related to the belief that one's genitalia are retracting into the body and may lead to death.

bubble_chart Diagnosis

I. Characteristics of Onset:

There is a susceptible population, more likely to occur in individuals with lower intelligence and weaker superego, high suggestibility, sensitivity, anxiety, and neuroticism. Before the onset, there are certain folk superstitious beliefs (such as ghosts or deities causing harm) and certain triggering events that prompt susceptible individuals to develop the condition.

II. Main Symptoms:

(1) Psychiatric symptoms, including terrifying anxiety, which can reach the severity of panic attacks in severe cases. During episodes, individuals may feel their genital organs (penis, breasts, vaginal orifice) retracting into their bodies, experiencing dysphoria, restlessness, and a sense of impending death. Each episode lasts from several minutes to ten minutes before subsiding. It may also manifest as perceptual disturbances, such as sensations of genital contraction, pain, numbness in other body parts, and hallucinations (e.g., hearing ghostly screams or door-opening sounds). These hallucinations are psychogenic, and some individuals may experience impaired consciousness—confusion—with no recollection afterward.

(2) Autonomic nervous symptoms: May include flusteredness, shortness of breath, pale complexion, sweating, elevated blood pressure, urinary urgency, vertigo, etc.

III. Physical Examination Findings:

Some may exhibit genital injuries or ulcers due to forceful clamping of the genital area with the legs during episodes.

This condition should be distinguished from secondary koro syndrome caused by organic brain diseases or schizophrenia.

bubble_chart Treatment Measures

Do not crowd around during an episode; maintain silence. Active psychological treatment should be provided, explaining the nature of the condition to the patient to alleviate fear. Appropriate anti-anxiety medication may be used when agitation occurs. Combating superstition and improving the cultural and psychological resilience of the population can help prevent the occurrence of this condition.