Alexander Teitelbaum

The Koro (Genital Retraction) Syndrome and Its Association With Infertility: A Case Report

The koro syndrome is a psychiatric disorder characterized by acute anxiety and a deep-seated fear of shrinkage of the penis and its ultimate retraction into the abdomen, which will cause death. Concurrence of the koro (genital retraction) syndrome with a pathological condition of the urogenital system has rarely been described. We report a case of koro associated with infertility. Within 3 weeks of treatment with haloperidol the classic symptoms of koro disappeared. To our knowledge this case represents the sixth report of the koro syndrome associated with urogenital pathology and the first report of its association with infertility.

Kleptomania : Diagnosis and treatment options

Kleptomania--the inability to resist the impulse to steal objects, not for personal use or monetary gain--is currently classified in psychiatric nomenclature as an impulse control disorder. However, some of the principle features of the disorder, which include repetitive intrusion thoughts, inability to resist the compulsion to perform the thievery and the relief of tension following the act, suggest that kleptomania may constitute an obsessive-compulsive spectrum disorder. Kleptomania is commonly under-diagnosed and is often accompanied by other psychiatric conditions, most notably affective, anxiety and eating disorders, and alcohol and substance abuse. Individuals with the disorder are usually referred for treatment due to the comorbid psychiatric complaints rather than kleptomanic behaviour per se. Over the past century there has been a shift from psychotherapeutic to psychopharmacological interventions for kleptomania. Pharmacological management using selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) and other antidepressants, mood stabilisers and opioid receptor antagonists, as adjuvants to cognitive-behavioural therapy, has produced promising results.

Male Genital Self-Mutilation in the Context of Religious Belief: The Jerusalem Syndrome

The objective of this article is to draw attention to the phenomenon of selfmutilation ‘sanctioned’ by religious belief. Jerusalem, the center of the world’s monotheist religions, is a powerful magnet, calling believers to come and there, perform certain prescribed actions. Witztum and Kalian (1999) note that ‘the eccentric conduct and bizarre performance of these colorful yet psychotic visitors become dramatically overt once they reach the Holy city – a geographical locus containing the “axis mundi” of their religious belief.’ The correlation between the meaning of Jerusalem as a place central to religious experience and the nature of some psychotic episodes has been characterized as ‘The Jerusalem Syndrome’ (Bar-El et al., 2000). As a syndrome rather than a distinct nosological entity, Jerusalem syndrome may appear in relation to the proximity to the Holy Places in people from all monotheistic religions with or without previous psychopathology. Three main versions of the Jerusalem syndrome are identifiable (Bar-El et al., 2000): (i) superimposed on previous psychotic illness; (ii) complicated