Koro: how culturally specific?

Koro has been described as an acute anxiety state related to the fear of penile shrinkage into the abdomen with resultant death. This partial depersonalization disorder is found primarily among the people of the Malay Archipelago and Southern Chinese, with extremely rare incidences documented in the West. The symptomology of Koro is commonly said to be linked to ancient Chinese medical beliefs on sexual functioning and is therefore referred to as a culturally bound syndrome. Our paper summarized the case of an American male with Koro-like symptoms. It compares the Western concept of penis loss to the Chinese or Malaysian concept, and then proposes a combined hypothesis for the development of Koro.