AN EPIDEMIC OF COLLECTIVE CONVERSION AND DISSOCIATION DISORDER IN AN INDIGENOUS GROUP OF COLOMBIA - ITS RELATION TO CULTURAL-CHANGE

We describe a collective episode of psychogenic illness in an indigeno us group (Embera) of Colombia, geographically isolated from its native homeland and surrounded by non-indigenous settlers. The condition, wh ich affected three young adult men and six adolescent women, was attri buted by them to a spell (maleficio). It was designated as ataques de locura (madness attacks) according to their traditional medical system ; and as a conversive disorder with dissociative features by psychiatr ists. Different therapeutic approaches, including antipsychotic medica tion, religious healers and traditional herbal remedies were unsuccess ful. Contact with shamans of the same ethnic origin, on the other hand , proved to be an effective way of dealing with the symptoms. We inter pret the situation as an expression of psychosocial stress secondary t o cultural change. This medical problem bears close resemblance to oth er specific culture-bound syndromes such as ataques de nervios or poss ession syndromes and gives clues to ways of dealing with psychogenic e xpressions of cultural stress. (C) 1998 Elsevier Science Ltd. All righ ts reserved.