Elsevier

Asian Journal of Psychiatry

Volume 31, January 2018, Pages 86-87
Asian Journal of Psychiatry

Letter to the Editor
Cannabis induced koro in a Nepali migrant

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Introduction

Koro is a term of Malay origin which has been applied for episodes of sudden and intense anxiety that the penis (or the vulva and nipples in females) will recede into the body possibly leading to death (Gwee, 1968). In earlier literature, cases of koro were reported to occur in isolated or epidemic pattern in southern China (Cheng, 1997), Malaysia (Gwee et al., 1969) and India (Dutta et al., 1982) making it a culture related disease. Recently it has been inferred that the psychological disappearance of the penis is an universal phenomenon (Mattelaer and Jilek, 2007). Koro is classified as “other specified obsessive-compulsive and related disorder” in DSM-5 (American Psychiatric Association, 2013).

Section snippets

Case report

Thirty year old married male immigrant labourer from Nepal presented in psychiatric outpatient department of our hospital in India with complaints of episodes of retraction of penis into abdominal cavity with pain in genital area during episode. Patient felt as if penis was shrinking and going to disappear within few minutes. The episodes would provoke intense anxiety when he experienced shortness of breath, fearfulness, hot and cold sensations all over body, headache and sensation of impending

Discussion

Acute anxiety and panic attacks have been reported following cannabis use(Thomas, 1996) but koro in the setting of cannabis use is uncommon. Cannabis induced koro has been reported in two Indian men who experienced shrinkage of the penis associated with their first consumption of the drug (Chowdhury and Bera, 1994). These Indian men were from the area where previously koro epidemic had occurred. These patients were cousins, and symptoms in second patient began a few days after first. Three

Conflict of interest

None.

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