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Das Syndrom der genitalen Retraktion aus Sicht der transkulturellen Psychiatrie

Chinesisches Suo yang, indonesisches Koro und nichtasiatische Formen (Koro-ähnliche Symptome)

The syndrome of genital retraction from a transcultural psychiatric point of view

Chinese suo yang, Indonesian koro and non-Asian forms (koro-like symptoms)

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Zusammenfassung

Die Arbeit fasst das Wissen zum Syndrom der genitalen Retraktion (SGR) aus Sicht der transkulturellen Psychiatrie zusammen. Am bekanntesten ist sein Vorkommen als kulturgebundenes Syndrom in Asien, z. B. Koro in Indonesien und Suo yang in Südchina, wo es auch in sog. „Epidemien“ auftritt. Das Bild ist gekennzeichnet durch das Erleben, dass das Genitale schrumpft und in den Bauch gezogen wird; damit einher geht Todesangst, da die Betroffenen befürchten zu sterben, sobald das Genitale vollständig verschwunden ist. Gerade beim Suo yang lässt sich die Einbindung der Symptomatik in lokale tradierte Krankheitsvorstellungen aufzeigen. In der westlichen Welt dagegen kommt das SGR nur in Einzelfällen vor. Die Symptomatik ist weniger dramatisch und zeigt keine kulturelle Einbindung. Man spricht von „Koro-ähnlichen Symptomen“ (koro-like symptoms, KLS). Im Unterschied zur asiatischen Form treten KLS nicht bei Gesunden auf, sondern als unspezifisches Syndrom bei verschiedenen neuropsychiatrischen Erkrankungen. Die beiden Formen des SGR werden hinsichtlich Symptomatik, kulturellen Aspekten und Therapieansätzen verglichen.

Summary

The present article reviews the syndrome of genital retraction (SGR) from the perspective of transcultural psychiatry. It is best known as a culture-bound syndrome in Asia, e. g. koro in Indonesia or suo yang in Southern China, where it can be also observed in so-called epidemics. The syndrome is characterised by the sensation that the genitals are shrinking and being pulled back into the abdomen; this perception is associated with fear of death, because the subjects expect to die as soon as the genital has disappeared completely. Particularly in the case of suo yang, the involvement of local traditional concepts of illness can be established. In the Western world, however, SGR is observed only in single cases. The symptoms are less dramatic and do not show a particular cultural context. This form of SGR is called “koro-like” (koro-like symptoms, KLS). In contrast to the Asian form, KLS are not observed in healthy subjects, but as an unspecific syndrome related to other neuropsychiatric illnesses. In this review, we compare both forms of the SGR in terms of symptoms, cultural aspects and therapeutic strategies.

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Danksagung

Wir danken Herrn Prof. W. Machleidt, Hannover, für zahlreiche wertvolle Hinweise zu früheren Formen dieser Arbeit.

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  1. Abt. Psychiatrie III, Universitätsklinikum Ulm

    R. W. Freudenmann & C. Schönfeldt-Lecuona

  2. Abteilung Psychiatrie III, Universitätsklinikum Ulm, Leimgrubenweg 12, 89075, Ulm, Deutschland

    R. W. Freudenmann

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Freudenmann, R.W., Schönfeldt-Lecuona, C. Das Syndrom der genitalen Retraktion aus Sicht der transkulturellen Psychiatrie. Nervenarzt 76, 569–580 (2005). https://doi.org/10.1007/s00115-004-1822-4

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