Region airs disease: A brief overview of culture bound syndromes

In a previous blog on coprophagia, I made a brief reference to Pibloktoq. Also known as Piblokto and Arctic Hysteria, the condition only manifests itself in winter among Inuhuit societies living (unsurprisingly) within the Arctic Circle. The condition is characterized by “an abrupt dissociative episode of intense hysteria, frequently followed by convulsive seizures and coma lasting up to 12 hours. Symptoms can include intense screaming, uncontrolled wild behaviour, depression, coprophagia, and insensitivity to extreme cold”.

Culture bound syndromes comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. They are often unknown outside of their own local regions. Even though the concept of culture-bound syndrome is highly controversial, the term was included in the American Psychiatric Association’s 1994 Diagnostic and Statistical Manual of Mental Disorders. Culture-specific syndromes are characterized by:

  • Categorization as a disease in the culture (i.e., not a voluntary behaviour or false claim);
  • Widespread familiarity in the culture;
  • Complete lack of familiarity of the condition to people in other cultures;
  • No objectively demonstrable biochemical or tissue abnormalities (symptoms);
  • The condition is usually recognized and treated by the folk medicine of the culture.

Today’s blog is a brief look at some of the different culture bound syndromes that exist around the world. In later blogs I am going to look at some of these in much greater detail, but for this article, I am just going to take a brief look at a few of the ones that I find psychologically interesting.

  • Beserkers is a culture-bound condition historically affecting Norsemen. The condition manifested itself among males only as an intense fury and rage (“berserkergang”) and mostly occurred in battle situations (but could also occur when they were engaged in labour-intensive work). When suffering the condition, it was alleged that the men affected were able to perform almost seemingly impossible super-human feats of strength. Those with beserkers were also said to experience a specific set of symptoms prior to the rage (i.e., beginning with shivering and chattering of their teeth, followed by a swelling and changing of colour in the face as they literally became ‘hot-headed’. The final stage was full-blown rage and fury accompanied by noisy grunts and howls. They would then just indiscriminately injure, maim and kill anything in their path. This would be followed by one or two days of feebleness, along with a dulling of the mind.
  • Koro is found primarily in Asian regions (e.g., China, Singapore, Thailand, India) and has been documented for thousands of years in those particular cultures. In essence, Koro refers to a kind of “genital hysteria” with “terror stricken” males believing that that their genitals are shriveling, shrinking up, retracting into the abdomen and/or disappearing, and that this ultimately leads to death (a so-called ‘genital retraction syndrome). The word ‘Koro’ is of Malayan-Indonesian origin and means ‘tortoise’ (presumably used to highlight the similarity between the retracting head and wrinkled neck of a tortoise and the belief that the male penis is retracting inside the body). Some psychologists have also speculated that Koro may be psychologically related to body dysmorphic disorder.
  • Wendigo is a psychotic mental disorder found primarily among Algonquian Native cultures in North America, but the frequency of Wendigo cases has declined rapidly in recent times because of Native American urbanization. It is also known by many variant names (including Windigo, Weendigo, Windago, Waindigo, Windiga, Witiko, and Wihtikow) and is part of a traditional belief system among the Oiibwe and Salteaux, the Cree, the Naskapi, and the Innu tribes. In essence, Individuals with Windigo believe that they are turning into cannibals and as a consequence have intense cravings for human flesh. Those with Wedigo were often executed as they typically threatened those they came into contact with. Although many have disputed whether the disorder exists, there are a significant number of substantiated eyewitness accounts (including Western anthrolopologists and ethnographers that demonstrate Wendigo is a factual phenomenon.
  • Gururumba is a culture-bound disorder found only in New Guinea and sometimes referred to as ‘Wild Pig Syndrome’. Affected individuals are typically married men who become “wild men” (i.e., engage in involuntary anti-social behaviour) and engage in stealing items from houses in their neighbourhood. The items stolen are usually of little value but those with Gururumba believe the objects stolen have value. Once stolen, the person decamps to local forests, lives there for a number of days and then returns empty handed, slurring their speech, and suffering from amnesia, hyperactivity, and clumsiness. Those from Gururumba believe that the illness is transmitted through being bitten by ghosts of recently deceased tribe members. There are also a number of reports from Papua New Guinea that eating various parts of plants and/or fungi can initiate the syndrome.
  • Saora Disorder is found only among the Saora tribe of Orissa State in India and is sometimes termed a ‘Shamanic initiatory illness’. Affected individuals can be male or female (and are typically teenagers or young adults) who display abnormal behaviour that Western health practitioners may define as a mental disorder. Those suffering often experience social stress from friends and relatives pressuring them to take on the life of a farmer against their wishes. Symptoms of Saora Disorder include inappropriate laughing and crying, amnesic episodes, fainting and passing out, and the experience of being constantly bitten by ants. Interestingly, the Saoran people blame the disorder on supernatural spirits who they claim want to marry the affected individual.
  • Shenkui (sometimes translated as ‘kidney weakness’) is a Chinese culture-bound syndrome in which male men suffer acute anxiety and/or panic symptoms accompanied by a range of physical symptoms but have no discernible underlying physical complaint. Shenkui symptoms can include intense tiredness, bouts of dizziness, intense aching and body weakness  (e.g., backache), insomnia, and sexual dysfunction (e.g., impotence, premature ejaculation). Chinese men attribute the effects of Shenkui to excessive loss of semen (via too much masturbation, frequent sexual intercourse, and wet dreams). Chinese men believe the condition to be life threatening because excessive semen loss is thought to represent the loss of life’s vital essence (a result from a deficiency in yang). A similar condition exists in India and other South Asian cultures, where it is known as dhat.
  • Ghost Sickness is a culture-bound psychotic disorder found among Navajo Native Americans. Members of these tribes think the disorder is highly associated with death. For instance, those afflicted are often mildly obsessed with a deceased person whom they believe to be the source of their problem. One of the major symptoms of the condition is an intense feeling of suffocation and terror because the affected person feels as though they are being buried alive with a friend or loved one. Other reported symptoms include general weakness and apathy, a loss of appetite, and recurring nightmares. The Navajo primarly attribute the condition to ‘chindi’ (ghosts), although sometimes it is attributed to witchcraft. Dr. Robert Putsch writing in a 2007 issue of the journal Drumlummon Views says that: “spirits or ‘ghosts’ may be viewed as being directly or indirectly linked to the cause of an event, accident, or illness”.
  • Grisi Siknis (which roughly translates as “crazy sickness” and is also known as ‘grisi munaia’, ‘Chipil siknis’ and ‘Nil siknis’) is a culture-bound disorder that is primarily found among the Miskito People of eastern Central America. Most affected individuals are young women (typically 15 to 18 years of age) and the disorder is considered contagious. According to Dr. Phil Dennis in a 1981 issue of Medical Anthropology, grisi siknis is typically characterized by long periods of anxiety, nausea, dizziness, irrational anger and fear, interlaced with short periods of rapid frenzy. When a Gris Siknis sufferer has an attack they completely lose consciousness. They then fall to the floor and after regaining consciousness they become (like berserkers above) almost super-human. They feel no pain, feel invincible, may speak in tongues, and will attack anyone near them believing that they are ‘devils’. Alleged eyewitness accounts have claimed that some affected individuals will vomit up strange things (coins, hair, and even spiders). Once the attack is over, they have no memory of anything that has happened. According to Dr. Dennis, the Meskito people believe grisi siknis is caused by possession by evil spirits

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Bartholomew, R. (2008). Penis panics. In R. Heiner (Ed.), Deviance across cultures (pp. 79–85). New York: Oxford University Press.

Dennis, P.A. (1981). Part three: Grisi Siknis Among the Miskito. Medical Anthropology, 5, 445–505.

Garlipp, P. (2008). Koro – A culture-bound phenomenon intercultural psychiatric implications. German Journal of Psychiatry, 11, 21-28.

Newman, P. (1964). ‘Wild Man’ behavior in a New Guinea Highlands community. American Anthropologist, 66, 1-19.

Newman, Philip L. (1981). Sexual politics and witchcraft in two New Guinea societies. In G.D. Berremen (Ed.), Social Inequality: Comparative and Developmental Approaches, (pp.103-121). New York: Academic Press.

Phillips, K. (2004). Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry, 3, 12-17.

Putsch, R.W. (2007). Ghost illness: A cross-cultural experience with the expression of a non-Western tradition in clinical practice. Drumlummon Views, Winter, 126-145.

Sumathipala, A., Siribaddana, S.H. & Bhugra, D. (2004). Culture-bound syndromes: The story of dhat syndrome. British Journal of Psychiatry, 184, 200-209.

Wikipedia (2012). Culture-bound syndrome. Located at:

Wikipedia (2012). Ghost sickness. Located at:

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 600 research papers, four books, over 130 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on June 25, 2012, in Compulsion, Culture Bound Syndromes, Mania, Obsession, Psychiatry, Psychological disorders, Psychology, Sex and tagged , , , , , , , , , . Bookmark the permalink. Leave a comment.

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