Koro : a Peculiar Anxiety Neurosis (a Case Report)

The term 'Koro' refers to an unfamiliar state of acute anxiety with partial de-personalization leading to the conviction of penile shrinkage and to fears of dissolution. Corresponding female cases have been described, allected women complained of shrinking of the vulval labia and the breasts (Lehmann, 1980). The Koro phenomenon must have spread from China to Indonesia and adjoining lands with Chinese migration (Yap, 1965). Among the South Chinese Koro is known as Suk-Yeong. Koro in Malay means the head of a turtle (or tortoise). The Chinese until the Ming Dynasty used the turtle as an artistic and literary symbol for longivity and the vital forces but later the symbol acquired scatlogical connotations. There is obvious similarity between the head of this long-lived creature and the glans penis. CASE REPORT S. S., 19 years old college student, son of aJCO reported to Psychiatric OPD of Military Hospital Ahmedabad on 15.1.1981 with the complaints of generalised weakness, frequent nocturnal emission and a feeling that His penis was getting smaller day by day of 2 years duration. He was unable to continue his studies. He had been to different places in Civil including allopathic, ayur-vedic doctors and local healers, but his symptoms gradually increased day by day. Subsequently, he reported to MH when he was referred to Psychiatric OPD by Surgeon. He was apprehensive and manifested somatic signs of anxiety in the form of mild tachycardia (P-96/min), moist and cold palms and fine tremors. He showed preoccupation over his somatic symptoms and apprehension of losing vital sex organ. He attributed his illne.s due to excessive masturbation, he used to do earlier. But since he stopped masturbation he had been getting frequent nocturnal emission. No past or family history of mental illness was detected. No psychotic features were detected. Premorbid personality was of Schizoid type. On his third visit, it was noticed that he used to keep his right hand always in his pocket. When asked why he kept his hand in his pocket, he replied that he held his penis so that it would not disappear into his abdomen, an interesting observation related to a hole in his trouser pocket. He was placed on anxiolytics and supportive psychotherapy but the response was not that satisfactory except that there was some improvement in his anxiety and in frequency of nocturnal emission, but physical weakness and Ideas about shrinkage of penis persisted. Neuroleptic was added …