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At least 19 recordsLinked to original sources
PubMed2000

Mass psychogenic illness: role of the individual physician.

Mass psychogenic illness is characterized by symptoms, occurring among a group of persons with shared beliefs regarding those symptoms, that suggest organic illness but have no identifiable environmental cause and little clinical or laboratory evidence of disease. Mass psychogenic illness typically affects adolescents or children, groups under stress and females disproportionately more than males. Symptoms often follow an environmental trigger or illness in an index case. They can spread rapidly by apparent visual transmission, may be aggravated by a prominent emergency or media response, and frequently resolve after patients are separated from each other and removed from the environment in which the outbreak began. Physicians should consider this diagnosis when faced with a cluster of unexplained acute illness.

Acute Disease↗
PubMed1985

Occupational mass psychogenic illness. History, prevention, and management.

Occupational mass psychogenic illness is a poorly understood phenomenon that is probably underreported in the literature. Several recent outbreaks illustrate the main features, including explosive onset usually triggered by a physicochemical stimulus; disproportionate involvement of relatively uneducated, low-paid women who perform highly routine tasks; diverse symptoms with scarcity of physical signs or laboratory findings; frequent absence of usual symptoms caused by the putative contaminant; recurrences in affected individuals when they congregate; and benign morbidity and lack of sequelae. Inappropriate handling of these outbreaks can lead to prolonged employee disability and disrupted production. Though the etiology of epidemic psychogenic illness often remains uncertain, a sufficient body of knowledge exists to plan a rational prevention and management program.

Disease Outbreaks↗
PubMed2000

Mass psychogenic illness attributed to toxic exposure at a high school.

BACKGROUND AND METHODS: Mass psychogenic illness may be difficult to differentiate from illness caused by bioterrorism, rapidly spreading infection, or toxic substances. We investigated symptoms attributed to exposure to toxic gas at a high school in Tennessee. In November 1998, a teacher noticed a 'gasoline-like' smell in her classroom, and soon thereafter she had a headache, nausea, shortness of breath, and dizziness. The school was evacuated, and 80 students and 19 staff members went to the emergency room at the local hospital; 38 persons were hospitalized overnight. Five days later, after the school had reopened, another 71 persons went to the emergency room. An extensive investigation was performed by several government agencies. RESULTS: We were unable to find a medical or environmental explanation for the reported illnesses. The persons who reported symptoms on the first day came from 36 classrooms scattered throughout the school. The most frequent symptoms (in this group and the group of people who reported symptoms five days later) were headache, dizziness, nausea, and drowsiness. Blood and urine specimens showed no evidence of carbon monoxide, volatile organic compounds, pesticides, polychlorinated biphenyls, paraquat, or mercury. There was no evidence of toxic compounds in the environment. A questionnaire administered a month later showed that the reported symptoms were significantly associated with female sex, seeing another ill person, knowing that a classmate was ill, and reporting an unusual odor at the school. CONCLUSIONS: The illness attributed to toxic exposure had features of mass psychogenic illness - notably, widespread subjective symptoms thought to be associated with environmental exposure to a toxic substance in the absence of objective evidence of an environmental cause. Alleviation of the anxiety surrounding an episode of mass psychogenic illness requires prompt recognition and a detailed investigation.

Disease Outbreaks↗
PubMed1986

Epidemic psychogenic illness in a telephone operators' building.

Epidemic psychogenic illness or mass hysteria occurred in a telephone operators' building following a pronouncement by an operator of toxic fume exposure. Two outbreaks occurred within two days, resulting in mass evacuation and closure of the building. Extensive environmental studies failed to identify a causative substance. Eighty-one employees were treated in emergency medical facilities for clinical and laboratory findings compatible with anxiety and hyperventilation. Characteristics of this work group were similar to those described in other epidemics, suggesting a pattern for susceptibility. Failure of early recognition and overreaction by supervisors and various outside groups and agencies contributed to escalation of the epidemic.

California↗
PubMed2003

Mass psychogenic illness after vaccination.

When vaccines are administered to groups, the physical reactions of the recipients may be similar, causing a form of mass reaction, the mechanism for which is the same as that for mass reactions from other causes. These phenomena have been categorised as mass psychogenic illness (MPI), and have been defined as the collective occurrence of a constellation of symptoms suggestive of organic illness but without an identified cause in a group of people with shared beliefs about the cause of the symptom(s). A review of the literature shows that such outbreaks have been reported in differing cultural and environmental settings including developing and industrialised countries, in the work place, on public transport, in schools, and the military. The perceived threats have been against agents such as food poisoning, fire and toxic gases. Whatever the place or perceived threat, the response seems to be similar. The symptoms generally included headache, dizziness, weakness, and loss of consciousness. Once under way, MPIs are not easy to stop. Incidents reported in the literature show that they can quickly gather momentum and can be amplified by the press who disseminate information rapidly, escalating the events. Management of such mass events can be extremely difficult. Should the public health official in charge continue to try and determine the cause, or should this person call off the entire investigation? It is suggested here that once vaccines are identified as a probable cause of the phenomenon, a dismissive approach may actually be harmful. Unless the spokesperson has already earned a high level of trust, the public are not likely to be convinced easily that nothing was wrong with the vaccine until it has been tested. An increased awareness of MPIs on the part of organisers of future mass vaccination campaigns seems appropriate. Immunisation managers should be aware that mass immunisation campaigns could generate such mass reactions. It is therefore essential that surveillance/reporting systems for reporting adverse events be improved before such campaigns. A mass campaign using a smallpox vaccine should be accompanied by a surveillance system capable of distinguishing between multiple cases of conventionally understood vaccine reactions and outbreaks of mass psychogenic illness.

Humans↗
PubMed2000

Industrial mass psychogenic illness: the unfashionable diagnosis.

Two previously unpublished outbreaks of Mass Psychogenic Illness (MPI) in Italy are reported. The first outbreak involved 427 female workers at an electro-mechanical plant. Workers complained of work-related stressors, and high levels of conflict between their job and home duties. We conclude that the episode resulted from the interaction of environmental and work-related factors, the persons and the social organization of the workplace. The second case is one in which risk of MPI developing seems to have been successfully prevented. An effective stress coping strategy, coupled with workplace improvement, may have succeeded in eliminating cases of illness and preventing an outbreak of MPI.

Adaptation, Psychological↗
PubMed1994

[Inadequate utilization of somato-medical services by psychogenically ill patients].

Within the Mannheim Cohort Project on the epidemiology of psychogenic disorders 240 probands of a high risk sample (suffering from medium psychogenic impairment) were randomly selected from the general population and investigated with regard to their realized utilization of the medical and/or psychotherapeutic services of the health care system. On the basis of clinical criteria the probands were classified as case (n = 78) of psychogenic disorder or non-case (n = 162). Increased psychogenic impairment caused by psychoneurotic, character neurotic, or psychosomatic-functional disorders was primarily combined with an intensified utilization of the somatically oriented medical services. Only 2.5% of the cases indicated that the reason for their most recent visit to a physician was psychotherapeutic treatment. In view of the high percentage of psychogenic impaired patients in private practices and general hospitals this seems to be a particularly discrepant finding. In spite of the psychogenic nature of their complaints the cases were confronted with somatically oriented therapy offers like the non-cases. An increased psychogenic impairment did not lead to a qualitative alteration of the utilization of medical and/or psychotherapeutic services. Facing the fact that the utilization of somatically oriented medical services by psychogenic ill patients is still widespread but inadequate this finding is interpreted as indication for an essential demand of further studies on the determinants of psychotherapy acceptance.

Cohort Studies↗
PubMed1979

An investigation of apparent mass psychogenic illness in an electronics plant.

An investigation of a case of apparent mass psychogenic illness was undertaken in a midwestern electronics assembly plant. The plant employed 500 workers, of whom 80% were female. The illness outbreak involved a total of 90 female first shift workers who reported a variety of nonspecific symptoms such as headache, dizziness, and lightheadedness in response to a strange odor in the workplace. Although environmental testing revealed some localized concentrations of a few airbone contaminants, no environmental toxins were discovered that could account for the continuing outbreaks of illness. An ad hoc sample of affected and nonaffected workers was surveyed to assess the influence of psychological, sociological, and work environment factors in the outbreak. Analysis of the data revealed that affected workers reported more physical discomfort (temperature variations, poor lighting) in the workplace as well as psychological job stress (increase in workload, conflicts with supervisors) than did nonaffected workers. Moreover, affected workers scored significantly higher than nonaffected workers on personality tests measuring extraversion and hysteria traits.

Electronics↗
PubMed1990

An epidemic of respiratory complaints exacerbated by mass psychogenic illness in a military recruit population.

The authors report an episode of mass psychogenic illness exacerbating respiratory symptoms in military recruits. The epidemic occurred over a 10- to 12-hour period in September 1988, in a group initially complaining of cough and pleuritic chest pain. More than 1,800 men were evacuated from their barracks because of a suspected toxic gaseous exposure. Approximately 1,000 recruits developed at least one new symptom, 375 were evacuated by ambulance to receive further medical evaluation, and at least eight were hospitalized. Air sample testing from the area was unremarkable, and there were few abnormal physical examination or laboratory findings. The epidemiologic investigation included a questionnaire administered 2 weeks after the epidemic to 1,000 of the recruits involved. A total of 55% of those who completed the questionnaire reported the onset of at least one new symptom after supper, with at least 25% reporting the new onset of cough, light-headedness, chest pain, shortness of breath, headache, sore throat, or dizziness. A total of 18% received further medical evaluation. The development of new symptoms and the receipt of further medical evaluation were associated with evidence of physical stress, mental stress, and awareness of rumors of odors, gases, and/or smoke. This epidemic was unique because of its size and its occurrence in an all-male population.

Conversion Disorder↗
PubMed1994

Tarantism, dancing mania and demonopathy: the anthro-political aspects of 'mass psychogenic illness'.

This study questions the widely held assumption that the phenomenon known as mass psychogenic illness (MPI) exists per se in nature as a psychiatric disorder. Most MPI studies are problematical, being descriptive, retrospective investigations of specific incidents which conform to a set of pre-existing symptom criteria that are used to determine the presence of collective psychosomatic illness. Diagnoses are based upon subjective, ambiguous categories that reflect stereotypes of female normality which assume the presence of a transcultural disease or disorder entity, underemphasizing or ignoring the significance of episodes as culturally conditioned roles of social action. Examples of this bias include the mislabelling of dancing manias, tarantism and demonopathy in Europe since the Middle Ages as culture-specific variants of MPI. While 'victims' are typified as mentally disturbed females possessing abnormal personality characteristics who are exhibiting cathartic reactions to stress, it is argued that episodes may involve normal, rational people who possess unfamiliar conduct codes, world-views and political agendas that differ significantly from those of Western-trained investigators who often judge these illness behaviours independent of their local context and meanings.

Anthropology, Cultural↗
PubMed1978

An investigation of job satisfaction factors in an incident of mass psychogenic illness at the workplace.

An investigation was undertaken of an apparent outbreak of contagious psychogenic illness at an electronics plant in which approximately 50 females reported a variety of subjective nonspecific symptoms. The workers believed that the physical symptomatology was triggered by an unidentified odor in the plant which was not verified by environmental sampling for chemicals or by medical evaluations of affected workers. A random sample of non-affected and affected workers was surveyed by means of psychological health status inventories and epidemiological indices to determine the role that life-history, personality characteristics and job dissatisfaction had on susceptibility to illness. Results indicated that those workers reporting the highest level of perceived stress due to job dissatisfaction, family problems, and personal conflict were most likely to experience somatic symptoms. In the present study sources of dissatisfaction identified as potential precipitating factors of the illness outbreak were: 1) working conditions, 2) supervisory style, and 3) personal lifestyle.

Female↗
PubMed1997

Investigation of factors affecting mass psychogenic illness in employees in a fish-packing plant.

This study of the factors affecting the development of mass psychogenic illness (MPI) was carried out in a large fish-packing plant in New Brunswick, Canada. A total of 269 out of 270 plant employees (99.6%) participated in the study and of these, 208 cases were affected with symptoms of MPI and 61 controls were unaffected over a period of 2 1/2 months. A questionnaire was administered to participating employees to collect information about symptoms, demographic factors, work history, pre-existing medical problems, potential workplace triggering exposure factors, and various psychosocial factors. Multiple logistic regression indicated that the main factors associated with MPI, in decreasing order of importance, were skill creation in the job, odor perception, and female sex. Management of this incident required reassurance of employees that there was no hazardous exposure in the plant as well as recognition of the need to reduce underlying sources of stress in the work environment.

Adult↗
PubMed1989

A case study of stress and mass psychogenic illness in industrial workers.

Outbreaks of fainting, nausea, and weakness among several hundred workers led to an investigation of industrial conditions. Repeated and extensive monitoring failed to detect levels of any substance that might explain these reactions. In a subsequent investigation of the psychosocial environment, the authors used a combination of observations, inventories, and interviews to determine whether psychosocial factors might explain this phenomenon. A multiple regression analysis identified (in order of importance) work intensity, mental strain, work/home problems, education, and sex as independent predictors explaining 33% of the overall severity of illness. The work was high-pressured, repetitive, monotonous, and noisy. This profile is consistent with reports of mass psychogenic illness and with research indicating that such work can be distressing and unhealthy.

Age Factors↗
PubMed1984

An epidemic of psychogenic illness in an electronics plant.

We investigated an outbreak of illness in electronics plant workers. Questionnaire data revealed that 98 employees experienced symptoms, including light- headedness , headache, sleepiness, and numbness/tingling of the face or extremities. Attack rates by work station followed no apparent pattern. Extensive medical and environmental evaluation, including air sampling for numerous solvents and gases, provided no physical or chemical explanation for the epidemic. Compared with well employees, ill employees were more commonly female, complained more frequently of bothersome odors, and believed that greater danger existed of the illness recurring. Blood gas analyses of seven of 11 ill workers showed respiratory alkalosis, consistent with hyperventilation. The poorly defined nature of this illness, the absence of exposures to environmental contaminants in concentrations exceeding recommended limits, and the evidence of hyperventilation suggest that this outbreak was an incident of industrial psychogenic illness.

Adult↗
PubMed2001

Mass psychogenic illness following tetanus-diphtheria toxoid vaccination in Jordan.

In September 1998, more than 800 young people in Jordan believed they had suffered from the side-effects of tetanus-diphtheria toxoid vaccine administered at school; 122 of them were admitted to hospital. For the vast majority, their symptoms did not result from the vaccine but arose from mass psychogenic illness. The role played by the media, the children's parents, and the medical profession in the escalation of this mass reaction appeared, at first sight, to be unusual and even unique to the circumstances in Jordan at the time. A review of the literature showed, however, that this mass reaction was similar in many ways to previous outbreaks, even though the underlying causes varied. There are about 200 published accounts of mass responses to situations involving suspected poisoning or other events. Because such mass reactions are relatively rare and the triggers so diverse, individuals faced with responding to them are unlikely to have prior experience in how to handle them and are unlikely to take bold steps to prevent their escalation. Indeed they may be unaware that such events have been recorded before. The lessons learned from this incident in Jordan may help other immunization programme managers to handle crisis situations elsewhere.

Adolescent↗
PubMed2001

Pokémon contagion: photosensitive epilepsy or mass psychogenic illness?

We studied a reported illness outbreak occurring on December 16, 1997, involving more than 12,000 Japanese children who had various signs and symptoms of illness after watching an episode of a popular animated cartoon, Pokémon. While photosensitive epilepsy was diagnosed in a minuscule fraction of those affected, this explanation cannot account for the breadth and pattern of the events. The characteristic features of the episode are consistent with the diagnosis of epidemic hysteria, triggered by sudden anxiety after dramatic mass media reports describing a relatively small number of genuine photosensitive-epilepsy seizures. The importance of the mass media in precipitating outbreaks of mass psychogenic illness is discussed.

Child↗
PubMed1999

[Multiple chemical sensitivities: case definition, etiology and relations to allergy, poisoning, psychogenic illness etc].

Multiple Chemical Sensitivities (MCS) have been defined as an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful effects; no single widely accepted test of physiologic function can be shown to correlate with symptoms (Cullen MR, 1987). The etiology of MCS is hypothesized as a toxicant-induced loss of tolerance to multiple chemicals with subsequent manifestation of multiple-organ symptoms triggered by low-level exposure to such chemicals. The involvement of multiple organs might be attributed to a neurogenic switching mechanism. The final diagnosis of MCS is to rely on provocation of symptoms in a exposure chamber by a double-blind method. Relations of MCS to allergy, poisoning, psychogenic illness, chemical sensitivity, idiopathic environmental intolerances etc. are discussed in terms of case definition and etiology of these disorders.

Diagnosis, Differential↗
PubMed2003

Mass psychogenic illness following oral cholera immunization in Ca Mau City, Vietnam.

INTRODUCTION: Targeted cholera immunization of high-risk populations in Vietnam is conducted based on routine surveillance data. Following mass immunization of schoolchildren in Ca Mau City using an oral bivalent killed cholera vaccine, adverse reactions were noted. METHODS: Salient data were collected in a systematic fashion including the review of medical records; interview of the school principal, teachers, students, parents and doctors; and review of the storage and handling of the vaccine. FINDINGS: On 18 December 2001, 234 children at a primary school in Ca Mau City received the cholera vaccine. Within 1h of immunization, three children in one of the classrooms complained of trembling, nausea and headache and were brought to the library and soon other children followed. Out of 234, 97 (42%) pupils were affected and brought to the Municipal Health Center or Ca Mau Provincial Hospital. Those who were affected were younger (mean age=9.6 years; 95% CI=9.4-9.7) compared to those who were not affected (mean age=10 years; 95% CI=9.7-10.3; t-test=-2.4; P-value=0.02). The proportion of affected females among those who had received the vaccine (49/114 or 43%) was similar to the proportion in males (48/120 or 40%; RR=1.07; 95% CI=0.79-1.46). The most frequent presenting complaint was cold extremities (60%) followed by headache (27%). All affected children recovered and were discharged in a few hours. None reported any sequelae or relapse. Once the situation was recognized, the cholera immunization campaign was continued. Laboratory tests of vaccine samples from the same batch detected no abnormality or contaminating agent. DISCUSSION: The findings suggest that the children at primary school number 1 suffered from a mass psychogenic illness. This incident was unusual in that a similar number of boys and girls were affected, in contrast to the frequently reported preponderance of female cases. Furthermore the underlying cause was very quickly diagnosed, medical interventions were kept to a minimum, and no relapse was observed. Future vaccination campaigns have to assure that the families are informed in advance.

Administration, Oral↗