Wessely S, Wardle C J
Institute of Psychiatry, Denmark Hill, London.
Br J Psychiatry. 1990 Sep;157:421-4. doi: 10.1192/bjp.157.3.421.
"In a cluster of illness reported among students at an elementary school parents mentioned many signs and symptoms including headache, pallor, dark circles under the eyes, nausea, and vomiting--which they attributed to exposure to recurrent leaks of natural gas at the school. It is likely that the parents spread among themselves the notion of toxic exposure at the school. A questionnaire revealed no spatial clustering, but increased reports of symptoms were related to intense media coverage. A thorough environmental and epidemiological investigation was negative, there being no evidence of a continuing gas leak or other potential causes. At a strictly biological level, the complaints in this reported 'cluster' apparently represented the sporadic occurrence of common childhood illnesses. The possibility of an epidemic from toxic exposure at the school caused intense parental concern and led to a major public health problem. The established term 'mass sociogenic illness' seems inapplicable here because complaints did not come principally from the students and the apparent epidemic illness was not transmitted among them. The term 'mass sociogenic illness by proxy' is proposed to describe this incident, in which transmission in one group (the parents) resulted in reports of an epidemic in another group (students)."
在一所小学学生中报告出现的一系列疾病中，家长们提到了许多体征和症状，包括头痛、面色苍白、黑眼圈、恶心和呕吐——他们将这些归因于学校天然气反复泄漏。家长们很可能在彼此之间传播了学校存在有毒物质暴露的观念。一份调查问卷显示不存在空间聚集性，但症状报告的增加与媒体的大量报道有关。全面的环境和流行病学调查结果为阴性，没有证据表明存在持续的天然气泄漏或其他潜在原因。从严格的生物学层面来看，此次报告的“聚集性疾病”中的这些主诉显然代表了常见儿童疾病的散发性发生。学校有毒物质暴露引发疫情的可能性引起了家长们的强烈担忧，并导致了一个重大的公共卫生问题。既定术语“群体性心因性疾病”在此处似乎并不适用，因为主诉并非主要来自学生，而且明显的疫情疾病也未在他们之间传播。本文提出“代理群体性心因性疾病”这一术语来描述该事件，即一组人群（家长）中的传播导致了另一组人群（学生）中出现疫情报告。
