Koro : Clinical and Historical Developments of the Culturally Defined Genital Retraction Disorder

This book provides a definitive account of koro, a topic of long-standing interest in the field of cultural psychiatry in which the patient displays a fear of the genitals shrinking and retracting. Written by Professor A.N. Chowdhury, a leading expert in the field, it provides a comprehensive overview of the cultural, historical and clinical significance of the condition that includes both cutting-edge critique and an analysis of research and accounts from the previous 120 years published literature. The book begins by outlining the definition, etymology of the term, and clinical features of koro as a culture-bound syndrome, and contextualizes the concept with reference to its historical origins and local experience in Southeast Asia, and its subsequent widespread occurrence in South Asia. It also critically examines the concept of culture-bound disorder and the development of the terminology, such as cultural concepts of distress, which is the term that is currently used in the DSM-5. Subsequent chapters elaborate the cultural context of koro in Chinese and South Asian cultures, including cultural symbolic analysis of associations with animals (fox and turtle) and phallic imagery based on troubling self-perceived aspects of body image that is central to the concept. The second section of the book offers a comprehensive, global literature review, before addressing the current status and relevance of koro, clinically relevant questions of risk assessment and forensic issues, and research methodology. This landmark work will provide a unique resource for clinicians and researchers working in cultural psychiatry, cultural psychology, anthropology, medical sociology, social work and psychosexual medicine. Arabinda Narayan Chowdhury is a Consultant in Adult Psychiatry and is currently working at Leicestershire Partnership NHS Trust, UK. Before joining the NHS, he worked as Professor and Head of the Institute of Psychiatry, Kolkata, India. Professor Chowdhury's research interests include Cultural and Social Psychiatry, with a particular focus on Eco-Psychiatry but with a special focus on koro, on which he has contributed over 50 articles and chapters Foreword Preface Acknowledgments Introduction Comment Contents Abbreviations Medications Mentioned List of Figures List of Tables Part I Introduction: Current Status 1 Koro: Definition, Etymology, and Clinical Features Definition Clinical Features Historical Background Linguistic Origin of the Term “Koro”/“Suo Yang” or “Shook Yang” Changing Nosology and Concept of KORO: A Brief Outline Global Distribution of Koro or Genital Retraction Epidemics Changing Spectrum of Koro Symptomatology Africa in the Koro Map References 2 Perceptual Deviation in Penis Image References Part II Historical Perspective 3 Culture-Boundness of Koro: Yin-Yang Dualism and Sexuality in Chinese Culture—A Psycho-Historical Note Suo-Yang: A Millennium-Old Traditional Belief Genital Retraction Illness in Chinese Medical Classics Orality and Sexual Anxiety in Chinese Culture Conclusion References 4 Koro and the Animal Connection Koro and the Fox-Myth China Japan Korea Vietnam Other Cultures Koro and the Tortoise Connection TORTOISE/TURTLE: Zoological Features TORTOISE: The Chinese Perspective TORTOISE: The Indian Perspective Kurma or Tortoise Incarnation of Vishnu: A Reflection of Mighty-Retraction of Energy Kaurma or Tortoise Love Position References 5 Loss of Cultural Tag of Koro Introduction Methods Late 19th Century: Dutch Credit in the “Birth of Koro” The Early Half of 20th Century: Koro's Broader Western Familiarity The Decade of 1950–1970: Yap-Rin and Gwee Era The Decade of 1971–1980: Shifting of Cultural Focus The Decade of 1981–1990: Ethno-Cultural Diversity of Koro The Decade of 1991–2000: Biology of Koro The Decade of 2001–2010: Universality of Koro The Decade of 2011–2020: New Diagnostic Berth for Koro Points in Favor Points Against Koro as a “Symptom,” not a Diagnostic Entity Conclusion References Part III Literature Review 6 Western Publications: Part One—From 1874 to 1970 Nineteenth-Century Publications on Genital Retraction or Koro Koro Literature: From 1901 to 1950 Koro Literature: From 1951 to 1960 Koro Literature: From 1961 to 1970 References 7 Western Publications: Part Two—From 1971 to 2000 Koro Literature: From 1971 to 1980 Koro Literature: From 1981 to 1990 KORO LITERATURE: From 1991 to 2000 References 8 Western Publications: Part Three—From 2001 to 2020 KORO LITERATURE: From 2001 to 2010 KORO LITERATURE: From 2011 to 2020 References 9 Indian Koro Research Publications: From 1943 to 2020 References 10 Risk Assessment and Forensic Aspect of Koro Introduction Methods Results and Discussion Social Paranoia Induced Koro Social or Folk Treatment-Induced Health Risk in Koro Koro Induced Social Paranoia Risk to Self or from Others Penis-Theft Epidemic in Africa—A Koro Variant with High Forensic Risk Conclusion References 11 Koro Research Methodology Introduction Research Issues References Index