Mass Psychogenic Illnesses

Vidhika Gadia

Mass Psychogenic Illness (MPI), also known as mass sociogenic illness is defined as the rapid spread of illness signs and symptoms affecting members of a cohesive group, originating from a nervous system disturbance involving excitation, loss, or alteration of function, whereby physical complaints that are exhibited unconsciously have no corresponding organic etiology” (Bartholomew, 2002). In other words, it involved the spread of symptoms of illnesses through a certain group or population where there is no organic or environmental cause for the symptoms. It differs from delusions as it involves physical symptoms. For the standard psychiatric nomenclature, mass psychogenic illnesses are under the general heading of “somatoform disorder”, and are subcategorised as “conversion disorder” or “hysterical neurosis, conversion type” (Bartholomew, 2002).  Two types of mass psychogenic illness have been defined, the first being ‘Mass Anxiety Hysteria’, which is of a shorter duration, typically a single day, and involves sudden, extreme anxiety following the perception of a false threat. The second is ‘Mass Motor Hysteria’, and is defined by the slow accumulation of pent-up stress, dissociation, histrionics, and alterations in psychomotor activity, which persists for weeks or months. 

In this paragraph, I will discuss the epidemiology of MPI. Adolescents and children are found to be the most affected in cases of MPI. A preponderance of female participants also exists. However, it has been hypothesised that intense media coverage exacerbates outbreaks, as illness may occur after the initial outbreak. There is no population or demographic group that is more prone to MPI, and according to Bartholomew, it is a behavioral reaction that anyone can show under the right circumstances. 

In the following two paragraphs, I will describe some prominent cases of MPI, beginning with the Kosovo Student Poisoning. This refers to the alleged poisoning by toxic gas of thousands of young Kosovars, particularly the Albanian ethnicity on 20th March 1990. Several months after a unilateral decision by the Serbian government to segregate schools (between Albanian and Serbian ethnicities) in the province of Kosovo, a mass “poisoning” of school children began to appear. Some schoolchildren found a ‘white powder’ on their desks, and upon touching it, began to show symptoms of froth around the mouth, cramps, and fainting. Approximately 7,500 Albanians were affected by this illness for the entirety of the year. While the Serbian authorities treated the illness as legitimate while it lasted, around 1995, there was a growing consensus that a large fraction of cases was actually a product of mass hysteria, or MPI. This is because not only did the cases meet all the criteria for MPI, but also there was a lack of physical evidence in these cases. The Kosovo Student Poisoning is a good example of how one infection amongst a group can cause symptoms in others based on a perceived threat, as the symptoms were quick to both appear and disappear. A major cause was the volatile and tense cultural situation in the province, and the tension from that manifested itself in the form of illness among young students. 

In this paragraph, I will describe the day-care sex-abuse hysteria that occurred in the United States in the 1980s. It featured charges against day-care providers of child abuse, ranging from sexual abuse to subjection to Satanic rituals. This hysteria began with the McMartin Preschool, when several teachers were accused to kidnapping children, forcing them to participate in group sex, and animal abuse. The case began with a single accusation that has since been proven false, but later expanded to include many teachers. Once the case went to trial, there were multiple criticisms regarding the leading questions asked by the investigators to coax the children into falsely accusing the teachers. The case led to a nation-wide panic and was the main cause of over a hundred similar accusations in the United States, Canada, New Zealand, Brazil, etc. Most of the allegations were found to be false and were found to meet the criteria for MPI. The reason attributed to the spread of the hysteria has largely been chalked up to a large percentage of mothers joining the workforce and having to leave their young children with relative strangers. Anxiety and guilt over this created a climate of fear and readiness to believe false accusations, leading to the huge number of cases. 

There remains a large amount of research to be done on MPIs, as lack of a detectable cause is usually the main criterion for diagnosis. More research should ideally show how an MPI occurs and what can be done to manage it. 

References

Bartholomew, Robert; Wessely, Simon (2002). "Protean nature of mass sociogenic illness" (PDF). The British Journal of Psychiatry. 180: 300–306.

Pendergrast, Mark (1996). Victims of Memory: Sex Abuse Accusations and Shattered Lives.

Wassenius, Goran. The mysterious disease. p. 16.

Weir, Erica (2005). "Mass sociogenic illness". Canadian Medical Association Journal.