Inadequate attention has been given to verifying the psychometric attributes of the objective structured clinical examination (OSCE), yet its popularity has been increasing in recent years. Our 6 years' experience in Nigeria showed that OSCE is practicable in undergraduate psychiatry assessment and there is evidence over consecutive years that it has satisfactory reliability and criterion-based validity. The importance of students' feedback in assessing the quality of examination is reinforced, and subtle, less tangible elements which determine students' performance, such as social interactional mystique and some personality traits, are worthy of evaluative research.
A survey of 50 male and 50 female (N = 100) psychiatric outpatients of Lagos University Teaching Hospital was carried out. DSM III diagnoses of patients was determined from the case notes. Sociodemographic data were also recorded. Findings were analysed for inter-relationships of diagnoses, sociodemographic data and three belief categories (medical, psychosocial and supernatural). The expected predominance of supernatural beliefs was absent; psychosocial responses were greater than the supernatural. There was no relationship between psychoses and supernatural belief types.
In this paper I will describe an epidemic of a koro-like syndrome that occurred in Nigeria between the last week of October and the first week of November 1990. This epidemic occurred in a setting of severe economic depression amidst speculation about currency change and elections. In contrast to classical descriptions of koro, however, in the Nigerian epidemic, afflicted men claimed that their external genitalia had simply vanished. The onset involved a characteristic march of features: cue, flash, check and alarm. The cue was usually a touch, a verbal or written inquiry, or a handshake from a stranger. The flash was a fearful realization (often described as a shock, jolt, sinking feeling in the abdomen or scrotal spasm) that a sinister cue had been received. The individual then involuntarily reached for his genitals to check for their intactness. With the conviction that the genitals had vanished, he sounded a loud alarm. The victims were mostly men although women were also said to be afflicted.This syndrome was commonly understood as a supernatural occurrence in which the afflicted were robbed of their genitalia in order to magically benefit other people. People identified as benefitting from the 'genital theft'-who were often prosperous looking strangers or women-received very rough treatment at the hands of the alarmed crowd. Among the many emergent themes that may have contributed to the epidemic are male resentment of women's success during a period of social strain and the symbolic equation of masculine sexuality with economic, social and creative prowess in many cultural myths.
KORO-LIKE SYNDROMESKoro, a syndrome consisting of genital retraction accompanied by the fear that death would occur following complete retraction into the
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