Halimi Aram, Jarrahi Alireza Mosavi, Kian Naghmeh, Nejadghaderi Seyed Aria, Jorjani Goljamal, Keramatinia Aliasghar, Al-Marzouqi Amina, Shams Jamal, Adel Narges
Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Soc Psychiatry Psychiatr Epidemiol. 2025 Jun 19. doi: 10.1007/s00127-025-02949-6.
Mass psychogenic illness (MPI), also known as mass hysteria, is a phenomenon where a group of individuals exhibit similar symptoms without any identifiable organic cause. MPI outbreaks in school settings can lead to significant disruptions and psychological distress among students. This systematic review aimed to identify and characterize the factors contributing to the initiation and progression of MPI outbreaks in schools through an analysis of the existing literature.
A comprehensive search was conducted in electronic databases, including Cochrane Library, PubMed, Embase, and Web of Science to identify relevant articles published in English. Studies were screened based on predefined inclusion and exclusion criteria. Moreover, grey literature search, hand searching, and backward/forward citation searching were performed. Data extraction was performed using a standardized form to collect information on outbreak characteristics, contributing factors, and symptom patterns.
Nineteen studies were included. We identified 10 distinct factors associated with MPI outbreaks in schools, including (1) the spread of rumors and misinformation, (2) community pressure and persistent rumor dissemination, (3) lack of attention to mental disorders, (4) anxiety due to pseudo causation, (5) negative perception of the authorities, (6) the presence of psychological stressors, (7) media coverage and public anxiety, (8) physical proximity and perceived threat, (9) social media influence, and (10) psychological vulnerability. These factors were found to act as causal triggers or exacerbating elements, leading to the initiation and amplification of MPI outbreaks.
This study highlights the complex nature of MPI outbreaks in school settings and emphasizes the importance of understanding the social and psychological factors that contribute to their occurrence and spread. The identified factors can serve as valuable indicators for schools and health authorities to effectively manage and support students during such incidents. Further research is needed to explore the interplay of these factors in different cultural and educational contexts and to develop targeted interventions for the prevention and mitigation of MPI outbreaks in schools.
群体性心因性疾病（MPI），也称为群体性癔症，是一种一群人表现出相似症状但无任何可识别的器质性病因的现象。学校环境中的MPI暴发可导致学生出现重大干扰和心理困扰。本系统评价旨在通过对现有文献的分析，确定并描述导致学校MPI暴发的起始和发展的因素。
在电子数据库中进行全面检索，包括Cochrane图书馆、PubMed、Embase和Web of Science，以识别用英文发表的相关文章。根据预先定义的纳入和排除标准对研究进行筛选。此外，还进行了灰色文献检索、手工检索以及向后/向前引文检索。使用标准化表格进行数据提取，以收集有关暴发特征、促成因素和症状模式的信息。
纳入了19项研究。我们确定了与学校MPI暴发相关的10个不同因素，包括（1）谣言和错误信息的传播，（2）社区压力和持续的谣言传播，（3）对精神障碍缺乏关注，（4）因伪因果关系导致的焦虑，（5）对当局的负面看法，（6）存在心理应激源，（7）媒体报道和公众焦虑，（8）身体接近度和感知到的威胁，（9）社交媒体影响，以及（10）心理易损性。这些因素被发现是因果触发因素或加剧因素，导致MPI暴发的起始和扩大。
本研究突出了学校环境中MPI暴发的复杂性，并强调了理解促成其发生和传播的社会和心理因素的重要性。所确定的因素可作为学校和卫生当局在这类事件期间有效管理和支持学生的宝贵指标。需要进一步研究以探讨这些因素在不同文化和教育背景下的相互作用，并制定针对性干预措施以预防和减轻学校中的MPI暴发。
