Illusory Truth Effect

Some define truth by what it is not, rather than what it is. Some argue that fake news has no factual basis, which implies that truth is equated simply to facts[1].

The illusory truth effect is also known as the illusion of truth effect, validity effect, truth effect, or even the reiteration effect. It is the tendency to believe false information to be correct after repeated exposure to it.

This phenomenon was first identified in a 1977 study[2]. The study found that, hen truth is assessed, people tend to rely on whether the information is in line with their understanding or if it feels familiar. The first condition is logical, as people compare new information with what they already know to be true. Repetition makes statements easier to process relative to new, unrepeated statements, leading people to believe that the repeated conclusion is more truthful.

“Repeat a lie often enough and it becomes the truth”, is a law of propaganda often (wrongly) attributed to Joseph Goebbels (1897-1945), chief propagandist for the Nazi Party. another veriant is the große Lüge ('big lie'), a gross distortion or misrepresentation of the truth primarily used as a political propaganda technique.

The illusory truth effect has also been linked to hindsight bias, in which the recollection of confidence is skewed after the truth has been received.

Even incidental exposure reaches further than previously thought, with potentially consequential implications for concerns around mis- and dis-information[3].

The illusory truth effect plays a significant role in fields such as advertising, news media, political propaganda, and religious indoctrination. Conspiracy theories rely heavily on the illusionary truth effect. People with below average intelligence and low level schooling are prone to believing anything that aligns with their pre-existing beliefs.

[1] Paskin D: Real or fake news: Who knows? in Journal of Social Media in Society – 2018
[2] Hasher et al: Frequency and the conference of referential validity in Journal of Verbal Learning and Verbal Behavior - 1977
[3] Mikell, Powell: Illusory implications: incidental exposure to ideas can induce beliefs in Royal Society - 2025

Autogynephilia

Paraphilia can be described as an experience of recurring or intense sexual arousal to atypical objects, places, situations, fantasies, behaviors, or individuals. Paraphilias are contrasted with normal sexual interests, although the definition of what makes a sexual interest normal or atypical remains controversial.

The exact number and taxonomy of paraphilia is under debate. The DSM-5 adds a distinction between paraphilias and "paraphilic disorders", stating that paraphilias do not require or justify psychiatric treatment in themselves, and defining paraphilic disorder as "a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others".

The DSM-5 has specific listings for eight paraphilic disorders: voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder, sexual masochism disorder, sexual sadism disorder, pedophilic disorder, fetishistic disorder, and transvestic disorder. Other paraphilic disorders can be diagnosed under the Other Specified Paraphilic Disorder or Unspecified Paraphilic Disorder listings, if accompanied by distress or impairment.

But there's another type of paraphilia that seems to have been prevented from entering public awareness: Autogynephilia.

Autogynephilia (derived from Greek for 'love of oneself as a woman') is defined as a male's propensity to be sexually aroused by the thought of himself as a female. It is the paraphilia that is theorized to underlie transvestism and some forms of male-to-female (MtF) transsexualism. Autogynephilia encompasses sexual arousal with cross-dressing and cross-gender expression that does not involve women's clothing per se[1].

The problem with autogynephilia is that it offers predatory men the possibility to put on a wig and to claim that they 'are women' so they can 'rightfully' enter spaces that would normally be exclusively for women, like toilets, changing rooms, and prisons for females.

Political trans activists and their 'allies' have done everything they could to keep the concept of autogynephilia from public awareness. And yet, with excruciating slowness but apparent inevitability, it is doing just that.

Remember, autogynephilia is a disorder that needs treatment because of the symptoms used to diagnose any paraphilia: .. whose satisfaction has entailed personal harm, or risk of harm, to others.

[1] Anne A Lawrence: Autogynephilia: an underappreciated paraphilia in Advances in Psychosomatic Medicine - 2011

Ketamine Bladder Syndrome

Ketamine is often used for its anesthetic and analgesic effects on cats, dogs, rabbits, rats, and other small animals. It is frequently used in induction and anesthetic maintenance in horses.

Ketamine is a dissociative anesthetic used medically for induction and maintenance of anesthesia. It is also used as a treatment for depression and in pain management. Ketamine is an NMDA receptor antagonist which accounts for most of its psychoactive effects.

At anesthetic doses, ketamine induces a state of dissociative anesthesia, a trance-like state providing pain relief, sedation, and amnesia.

As a result of its dissociative and paralytic effects, ketamine is increasingly popular for 'recreational use'. But regular use can have some unexpected detrimental effects on your health. Serious and frequently irreversible damage to the urinary tract is a recently recognised an important side effect of that recreational ketamine use.

Ketamine is toxic for your bladder and urinary tracks. Urinary toxicity occurs primarily in people who use ketamine routinely, with around 25% of frequent users having bladder complaints. These complaints include a range of disorders from cystitis to hydronephrosis to kidney failure.

The typical symptoms of ketamine-induced cystitis are frequent urination, dysuria, and urinary urgency sometimes accompanied by pain during urination and blood in urine[1]. The damage to the bladder wall has similarities to both interstitial and eosinophilic cystitis. The wall is thickened and the functional bladder capacity is as low as 10–150 millilitres.

Management of ketamine-induced cystitis involves ketamine cessation as the first step[2]. This is followed by NSAIDs and anticholinergics and, if the response is insufficient, by tramadol. The second line treatments are epithelium-protective agents such as oral pentosan polysulfate or intravesical (intra-bladder) instillation of hyaluronic acid.

Guess who is a regular user of ketamine 'for his depression'? Elon Musk.

[1] Castellani et al: What urologists need to know about ketamine-induced uropathy: A systematic review in Neurourology and Urodynamics – 2020
[2] Srirangam, Mercer: Ketamine bladder syndrome: an important differential diagnosis when assessing a patient with persistent lower urinary tract symptoms in Britisch Medical Journal - 2012

Hound of the Baskervilles Effect

The Hound of the Baskervilles Effect, also known as the Baskervilles Effect, is the supposed self-fulfilling prophecy that there is an increase in rate of mortality through heart attacks on days considered unlucky because of the psychological stress this causes on superstitious people.

The term derives from the Sherlock Holmes novel 'The Hound of the Baskervilles' in which a hellish-looking dog chases Sir Charles Baskerville, sufferer of a chronic heart disease, and who subsequently dies of a heart attack "with an expression of horror in his face".

The Baskerville Effect was named by David Phillips and his colleagues at the University of California (San Diego, USA) in a paper in which they claimed that the daily number of deaths of Chinese and Japanese Americans from heart attacks between 1973 and 1998 was 7 percent higher on the fourth of the month compared to the average for the other days in that month, while this was not observed in the general American population[1].

Four is considered an unlucky number in Chinese, and hence in the Japanese and Korean, because it sounds like the Chinese word for 'death'. As a result of this superstition, some Chinese and Japanese hotels avoid using it as a room number.

In an analysis of the 20,000 computerized death certificates of Asian-Americans in San Diego, Phillips discovered that there was a 13 percent uptick in death rates on the fourth of the month. The hypothesis was that the peak was caused by stress induced by the superstition surrounding this number.

However, not everyone was convinced about this correlation. In 2002, Gary Smith commented that Phillips and colleagues had omitted data from several heart disease categories, picking only those that happened to have a higher rate on the fourth day, calling them 'chronic heart diseases'. Smith also pointed out that they had not done this on their previous studies of Jewish deaths near Passover and Chinese deaths near the Harvest Moon, where they had used all heart disease categories[2].

Smith also found no statistically relevant peaks on day 4 in data from 1969 to 1988 and 1999 to 2001 for total coronary deaths, inpatients, or the subset of heart diseases used by Phillips and colleagues, adding that there were more deaths on day 5 in the 1969–1988 data, and more deaths on day 3 in the 1999–2001 data.

In 2003, Panesar and colleagues looked for this effect on the Chinese population of Hong Kong. They looked at mortality data from 1995 to 2000, comparing the days of the month with "deathly connotations" (4, 14 and 24) with the other days of the month on both the Lunar and Gregorian calendars, and found no statistically significant difference in the occurrence of cardiac deaths in Cantonese people[3].

[1] Phillips et al: The Hound of the Baskervilles effect: natural experiment on the influence of psychological stress on timing of death in British Medical Journal – 2001. See here.
[2] Smith: Scared to Death? in British Medical Journal – 2002. See here.
[3] Panesar et al: Is four a deadly number for the Chinese? in Medical Journal of Australia – 2003.

Swollen Head Syndrome

Avian metapneumovirus (aMPV) causes turkey rhinotracheitis also known as avian pneumovirus infection of turkeys, which is an acute respiratory tract infection of turkeys. It is also associated with Swollen Head Syndrome also known as avian rhinotracheitis in broilers and broiler breeders, as well as with reproductive disorders that result in a marked drop in egg production in chickens and ducks.

The typical clinical signs seen in chickens infected with the virus include swelling of the periorbital and infraorbital sinuses, particularly around the eye, coupled with mild conjunctivitis. Some respiratory signs were also observed. The disease usually lasts from two to three weeks.

The Swollen Head Syndrome affects not only chickens, turkeys, and guinea fowl, but also pheasants, and Muscovy ducks. Furthermore, geese, most other duck species, and possibly pigeons are thought to be refractory to disease.

Respiratory signs occur in young birds and the adults are affected by drops in egg production, usually by from 5% to 30%. The transmission of the virus is lateral by aerosol through the respiratory route. It is spread by both airborne and mechanical (feed, water, and equipment) routes.

Avian metapneumovirus was first detected in turkeys in South Africa in the late 1970s, and has since spread to all major poultry-producing regions of the world, except Australia.

In 2001, the first human metapneumovirus (hMPV) was isolated in The Netherlands and classified as a member of the genus Metapneumovirus, which predominantly causes respiratory infections in humans.

Experimental studies suggest that turkeys also are susceptible to hMPV[1]. Complete genome sequencing has confirmed that the genomic organization of hMPV is similar to that of aMPV.

Vaccines are available for immunization of chickens and turkeys, and they are widely used in countries where the disease is endemic.

[1] Velayudhan et al: Human metapneumovirus in turkey poults in Emerging Infectious Diseases – 2006

Rebecca Syndrome

The Rebecca Syndrome is also known as Retroactive jealousy. It is the pathological emergence of jealousy towards an ex-partner of the current partner of the person experiencing it. In other words: It describes a severe form of pathological jealousy that a person experiences toward their partner's former lover.

The name of this syndrome was coined around the year 2006 by Dr. Darian Leader, a psychoanalyst and founding member of the Centre for Freudian Analysis and Research in London (UK). ,

The feeling of jealousy is considered pathological when it arises without solid grounds and when it reaches dimensions that affect the normal behavior of the person suffering from it.

This syndrome is named in homage to the novel Rebecca, written by Daphne du Maurier (1907-1989). The novel tells the story of Mrs de Winter who moves to Manderley with her new husband. She is haunted by the ghost of his late wife Rebecca - convinced he is still deeply in love with this seemingly perfect woman[1].

For some people, the Rebecca Syndrome is torturous. A relationship between two people might unconsciously be between three people. The ghost is always there.

The Rebecca Syndrome is not (yet) officially recognized as a psychological disorder in mainstream diagnostic classifications. It serves more as a cultural reference. The obsessions associated with this condition can lead to intrusive thoughts, stalking behaviors, and other negative consequences.

[1] Lee Glendinning: Rebecca syndrome: Or why increasing numbers of divorced and bereaved men are remarrying the 'ghosts' of their former wives in The Independent – 2006. See here.

Morton's Foot Syndrome

Morton's Foot Syndrome is known under a plethora of other names, such as Morton's toe, Morton's foot, Greek foot or Royal Foot.

This syndrome is characterized by a longer second toe. This is because the first metatarsal, behind the big toe, is short compared to the second metatarsal, next to it. It is a type of brachymetatarsia.

The most common symptom experienced due to Morton's Foot Syndrome is callusing and/or discomfort of the ball of the foot at the base of the second toe. The base of the big toe would normally bear the majority of a person's body weight during walking, but because the second metatarsal head is now farthest forward, the force is transferred there. Pain may also be felt in the arch of the foot, at the ankleward end of the first and second metatarsals.

Among the issues associated with Morton's Foot Syndrome is that the weight distribution causes the front of the foot to widen as the weight shifts from the first shortened toe to the others. Regular shoes will often cause metatarsalgia and neuromas as the shoe pushes together the toes. Wide shoes are recommended.

The name derives from American orthopedic surgeon Dudley Joy Morton (1884–1960)[1].

The ancient Greeks thought that having a long second toe was the best body feature. These big toes can still be seen in art and statues from Greece and Rome. Morton's Foot Syndrome is something that the Venus de Milo, Leonardo da Vinci's Vitruvian Man, and Michelangelo's David have.

The Vikings thought that if your second toe was long, you would live a long time.

Between 3% and 15% of people have a Greek toe.

[1] Schimizzi, Brage: Brachymetatarsia in Foot and Ankle Clinics - 2004. See here.

Todestrieb or Thanatos Urge

In classical Freudian psychoanalytic theory, the Todestrieb ('death drive') is the unconcious drive towards your own death and destruction. This is often expressed through behaviors Todestrieb into his theory, Freud’s fundamental opposition was between the Ichtriebe ('ego drive') and the Sexualtriebe ('sexual drive'), a differentiation that is founded on the two-fold role of each individual being.

Sigmund Freud (1856-1939) first used the term in his 1920 essay Jenseits des Lustprinzips ('Beyond the Pleasure Principle'), but he 'borrowed' it from Sabina Spielrein (1885-1942), who mentioned it earlier in her paper Die Destruktion als Ursache des Werdens ('Destruction as the Cause of Coming Into Being') from 1912.

The concept of Todestrieb has been translated as "opposition between the ego (or death instincts) and the sexual (or life instincts)". The Todestrieb opposes Eros, the tendency toward survival, propagation, sex, and other creative, life-producing drives.

The Todestrieb is sometimes referred to as the Thanatos Urge in post-Freudian thought (in reference to the Greek personification of death), complementing Eros, although this term was never used by Sigmund Freud himself.

The terminology Thanatos Urge or simply Thanatos was introduced by Wilhelm Stekel (1868-1940) in 1909, though he used the words to signify a death-wish.

Still, it is a little odd that Sigmund Freud himself never, except in conversation, used the term Thanatos for the death instinct, one that has become so popular since.

At first, Freud used the terms 'eath instinct' and 'destructive instinct' indiscriminately, alternating between them, but in his discussion with Albert Einstein about war he made the distinction that the former is directed against the self and the latter, derived from it, is directed outward.

Koala Immune Deficiency Syndrome

Koala Immune Deficiency Syndrome (KIDS) is caused by the Koala retrovirus (KoRV). An infection with this syndrome results an AIDS-like immunodeficiency that leaves infected koala (Phascolarctos cinereus) more susceptible to infectious disease and cancers.

Koala retrovirus is closely related genetically to gibbon-ape leukemia virus (GaLV), feline leukemia virus (FeLV), and porcine endogenous retrovirus (PERV)[1].

The Koala retrovirus is thought to be a recently introduced exogenous virus that is also integrating into the koala genome (becoming endogenous). Thus the virus can transmit both horizontally (from animal to animal in the classic viral sense) and vertically (from parent to offspring as a gene).

Koala retrovirus was initially described as a novel endogenous retrovirus found within the koala genome and in tissues as free virions. Analysis showed that KoRV is an active replicating endogenous retrovirus that can also produce infectious virions.

The analysis also showed that KoRV was closely related to the highly pathogenic gibbon ape leukemia virus (GALV).

Some 80% of all deaths of captive koalas in Queensland (Australia) from leukemia, lymphoma, malignant tumours, and immune deficiency disorders is attributable to the virus. The virus is considered a threat that could lead to extinction of koalas in Queensland within 15 years

Research has also shown that some populations of koalas, particularly an isolated colony on Kangaroo Island do not appear to have the endogenous form of the retrovirus. This suggests that the virus gene sequence is a rather new acquisition for the koala genome.

Prevalence of KoRV (and KIDS) in Australian koala populations suggests a trend spreading from the north down to the south of Australia.[ Northern populations are completely infected, while some southern populations are still free.

In 2013, an exclusively exogenous subtype of KoRV was identified and termed Koala retrovirus-B (KoRV-B), with the endogenous form of KoRV referred to as Koala retrovirus-A (KoRV-A)[2]. KoRV-B will likely remain exogenous and more pathogenic than KoRV-A, because the deleterious effects it causes in its hosts will not be selected against to the extent they would in a virus capable of integrating into the germ line. So far, nine subtypes of KoRV have been isolated (KoRV-A to KoRV-I).

Currently, no vaccine or effective treatment is available for KoRV or its associated neoplastic diseases.

[1] Kayesh et al: Koala retrovirus epidemiology, transmission mode, pathogenesis, and host immune response in koalas (Phascolarctos cinereus): a review in Archives of Virology - 2020
[2] Xu et al: An exogenous retrovirus isolated from koalas with malignant neoplasias in a US zoo in PNAS- 2012

Tiara Syndrome

The Tiara Syndrome is about women being too reluctant to apply for promotions even when they are well deserved, simply believing good job performance will naturally lead to rewards[1]. The term was coined by Carol Frohlinger and Deborah Kolb, the founders of Negotiating Women, Inc., an advisory firm committed to helping organizations to advance talented women into leadership positions.

The Tiara Syndrome is related to the Imposter Syndrome. Women often undervalue their skills and are less effective at self-promotion than their male counterparts. A number of strategies can help battle this syndrome and ease the stress of 'taking off the tiara'.

As Carol Frohlinger says, "Women expect that if they keep doing their job well someone will notice them and place a tiara on their head. That never happens."

Her comment was made particularly in relation to negotiating starting salary and pay rises which men tend to be more comfortable at doing than women. However, as Sheryl Sandberg writes in her (ghost-written) book 'Lean In: Women, Work, and the Will to Lead' (2013): "Women are also more reluctant to apply for promotions even when deserved, often believing that good job performance will naturally lead to rewards."

Of course a high level of performance is the entry ticket to career progress but sometimes this very diligence gets in the way of fast tracking your career. Many women I work with in the City explain that they are so busy doing the operational aspects of their job that they don't have time to step back and focus on strategic priorities, for example. Nor do they feel they have space in their busy working weeks to fit in networking which is seen as an unnecessary - and often uncomfortable - use of their precious time. Similarly they do not seek mentors to guide them or indeed the support of sponsors to give them the invaluable exposure and opportunities needed to step up to senior leadership positions.

Psychologist Cordelia Fine says such behaviour stems from socialisation, not innate differences between the sexes. Some men also suffer, just as many women may not, but similar to 'Imposter Syndrome' it does appear to be more of a female behaviour.

[1] Fitzpatrick, Curran: Waiting for your coronation: a career-limiting trap in Nursing Economics – 2014.

Grey Gorilla Syndrome

Assessment and decision-making skills are considered inherent to nursing, but what the underlying cognitive process involves or how it is developed and used has received much less attention. The process by which nurses link together basic knowledge, past experiences, and 'gut feelings' as a basis for decisions is called the 'Nursing Gestalt'. New nurses learn to make assessments, diagnoses, and sound judgements about care from a more experienced nurse who supports and teaches the neophyte. These researchers have called this mentoring relationship the Grey Gorilla Syndrome, in reference to the silverback primate who serves as a leader-teacher-protector-role model for his troupe.

Data were collected from interactions and in-depth interviews with 28 subjects from all levels of basic nursing who worked in medical intensive care units. The investigation studied the practice of these nurses in the early detection of cardiogenic shock. Nurses who had the support and guidance of Grey Gorillas expressed feelings of greater self-actualization, more job satisfaction, better peer relationships, and less stress. An emotional involvement and intense relationship developed between the Grey Gorilla and the neophyte. Units having a Grey Gorilla were observed to be quieter and more efficiently organized.

Barriers to this mentor-neophyte relationship are timing and accessibility since potential Grey Gorillas often have conflicting demands or work shifts. Organizational and managerial duties take up the time of head nurses and coordinators, and neophytes find themselves working evenings or nights with other equally inexperienced nurses. Some nurses with the necessary experience and expertise to assume a mentoring role are unapproachable or are reluctant to share their knowledge. Neophytes were not found to be reluctant or too competitive to enter into the relationship, and expressed regret only during the weaning phase.

The researchers suggest that problems of patient care, burnout, and turnover could be reduced by encouraging the use and development of Grey Gorillas, proving positive feedback, and recognizing their contribution.

Source: Pyles, Stern: Discovery of nursing gestalt in critical care nursing: The importance of the Grey Gorilla Syndrome in Journal of Nursing Scholarship - 1983

Immigration Delay Disease

Immigration Delay Disease is the somewhat jocular name of a genetic disorder called adermatoglyphia. This is an extremely rare genetic disorder that prevents the development of fingerprints. Just five extended families worldwide are known to be affected by this condition.

Adermatoglyphia - from Ancient Greek a- (ἀ-) 'not' + dérma (δέρμα) 'skin' + gluphḗ (γλυφή) 'carving' - is the absence of ridges on the skin on the pads of the fingers and toes, as well as on the palms of the hands and soles of the feet. The patterns of these ridges (called dermatoglyphs) form whorls, arches, and loops that are the basis for each person's unique fingerprints. Because no two people have the same patterns, fingerprints have long been used as a way to identify individuals.

The name 'Immigration Delay Disease' was coined by Professor Peter Itin, a Dermatologist, based in Basel (Switzerland), after his first patient had trouble traveling into the U.S. without any fingerprints for identification.

In 2010 an isolated finding was published regarding the description of a person from Switzerland who lacked fingerprints[1]. The heterozygous expression of the mutation suggests an autosomal dominant mode of inheritance. The Swiss patient, and eight of her relatives who also had the mutation, all had 'flat finger pads and a reduced number of sweat glands in the hands'.

The medical condition and the 2007 Swiss medical case are both mentioned in the episode entitled "She Was Murdered Twice" (Series 4, Episode 7) of the television series Death in Paradise.

[1] Burger et al: The immigration delay disease: Adermatoglyphia–inherited absence of epidermal ridges in Journal of the American Academy of Dermatology - 2010

Barbed Wire Disease

The Swiss physician Adolf Lukas Vischer (1884–1974) was an observer of the impact of the First World War on the human condition. In 1918 Vischer published an account of the psychological harm done to young men through the modern phenomenon of wartime captivity in POW and internment camps. The name of the book was Die Stacheldrahtkrankheit ('The Barbed-Wire Disease').

Vischer’s observations indicated that those who had been in enemy captivity for extended periods —two years or more— were also suffering from a particular kind of mental illness characterized by disinterest in life beyond the camp, restlessness and an inability to concentrate. He also witnessed similar symptoms among European and Indian POWs in Turkish captivity during an inspection tour with the Red Cross in Asia Minor in 1916–17, and again among German civilian internees on the Isle of Man and prisoners held in military and civilian camps on the British mainland.

This brought Vischer to the conclusion that what was already being dubbed ‘barbed-wire disease’ in some of the camp newspapers was a universal human response to being held behind barbed wire for prolonged stretches of time.

The syndrome was something common to all long-term prisoners. Furthermore, it was not eased or worsened by education, class, ethnicity or religion of any particular group of prisoners; rather, its sole cause was the fact of living behind barbed wire itself. The degree of severity depended primarily on the duration of captivity, not on experiences prior to capture.

At the same time in France, physicians also observed these same effects on captivity, but they invented their own term: cafard, from the Arabic kafir ('unbeliever') but with the currupted meaning of 'depression' or 'melancholy. They saw cafard as a form of spiritual home-sickness to be fought against and overcome, rather than as a medical condition that could only be treated, if at all, by release back into civilian life.

Though not exactly the same, modern researchers use the term 'institutionalization' or 'institutional syndrome' to describe deficits or disabilities in social and life skills, which develop after a person has spent a long period living in prisons or mental hospitals. These individuals may be deprived of independence and of responsibility, to the point that once they return to 'outside life' they are often unable to manage many of its demands.

Bromism

Bromism is the syndrome that results from the long-term consumption of bromine, usually through bromine-based sedatives such as potassium bromide and lithium bromide. Bromism was once a very common disorder, being responsible for 5 to 10% of psychiatric hospital admissions, but is now uncommon since bromide was withdrawn from clinical use in many countries and severely restricted in others.

Bromism is caused by a neurotoxic effect on the brain. The symptoms of bromism include mental dullness, memory loss, slurred speech, tremors, ataxia, and muscular weakness, a transitory state resembling paranoid schizophrenia, and a skin eruption called bromoderma. Eventually leading to somnolence, psychosis, seizures, and delirium.

High levels of bromide chronically impair the membrane of neurons, which progressively impairs neuronal transmission, leading to toxicity. Doses as small as 0.5 gram per day of bromide can lead to bromism.

While significant and sometimes serious disturbances occur to neurologic, psychiatric, dermatological, and gastrointestinal functions, death is rare from bromism.

Bromism has also been caused by excessive consumption of soda that contains Brominated Vegetable Oil, leading to headache, fatigue, ataxia, memory loss, and potentially inability to walk as observed in one case.

Brominated Vegetable Oil (or BVO) is a vegetable oil that is modified with bromine. As was (until recently) authorized, it was used in small amounts, not to exceed 15 parts per million, as a stabilizer for fruit flavouring in beverages to keep the citrus flavouring from floating to the top. Over time, many beverage makers have reformulated their products to replace BVO with an alternative ingredient. Today, few beverages in the U.S. contain BVO.

Brominated Vegetable Oils were already banned in Europe, but the American Food and Drugs Administration (finally) decided on July 3, 2024 to revoke its use as a food additive[1]. Sun Drop, manufactured by Keurig Dr Pepper, is the largest national brand in the US to still include the additive.

There is no specific treatment available for bromism. Increased intake of regular salt and water, which increases the flow of the related chloride ion through the body, is one way of flushing out the bromide.

You might think that you're now safe from bromine poisoning, but that's not entirely true: bromides can still be obtained as unregulated dietary supplements[2].

[1] FDA: Brominated Vegetable Oil (BVO). See here.
[2] Friedman, Cantrell: Mind the gap: Bromism secondary to internet-purchased supplements in American Journal of Emergency Medicine - 2022.

Sèvres Syndrome

Turkey has managed to consistently choose the wrong side of history over the last 200 years. This meant that the country supported the Germans in both the First and Second World Wars and therefore had to bear the consequences of the loss of the Axis. Twice.

Because both world wars were ultimately about territorial gain, the losing side was forced to make territorial concessions. After the First World War, the Treaty of Versailles ordered Germany to pay reparations in 1919, but also to make territorial concessions.

The Treaty of Versailles for Germany had its counterpart in the Treaty of Sèvres for Turkey. The 1920 Treaty of Sèvres was a pact between the Allies and the Ottoman Empire, officially dismantling the Ottoman Empire and forcing it to relinquish claims to territories in North Africa and the Middle East. It also recognized independent and autonomous areas for Armenia, Kurdistan, and Greece.

Turkey's pride was hurt, and the humiliation and the subsequent implosion of the Turkish army eventually resulted in widespread guerilla warfare, led by Mustafa Kemal (1881-1938), later glorified as Atatürk. As the Turks are especially adept at genocide, huge numbers of Greeks, Jews and Armenians were massacred during the 'War of Independence' in 1920. Even in 1955, a pogrom against Greeks and Greek properties was endorsed by the Turkish government.

The Treaty of Sèvres was never implemented since it was left unratified by the Ottoman Parliament and due to Turkish victory during the subsequent 'War of Independence'.

Still, the Treaty of Sèvres still has a psychological effect on modern Turks. So much that it has become a syndrome: The Sèvres syndrome (Sevr sendromu)[1]. It refers to a popular belief in Turkey that dangerous internal and external enemies, especially the West, are 'conspiring to weaken and carve up the Turkish Republic'.

This belief is simply a conspiracy theory, because no one would, in their right mind, want to carve up Turkey (again). But it did result in a sort of siege mentality among many Turks. Which is stupid, but conspiracy theories are mostly in the realm of stupidity.

The Sèvres Syndrome is also the reason that Turkey is turning its back on Europe and forging closer ties with Russia and its former satellites. Which is also why Turkey is expected to join the Shanghai Cooperation Organization (SCO), a regional organization helmed by China and Russia. The SCO has renowned members such as China, Russia, Kazakhstan, Kyrgyzstan, Tajikistan, India, Pakistan, Iran, and Belarus.

[1] Guida: The Sèvres Syndrome and “Komplo” Theories in the Islamist and Secular Press in Turkish Studies - 2008

Bald Sea Urchin Disease

Bald Sea Urchin Disease is a bacterial disease known to affect several species of sea urchins in the Mediterranean Sea, North Atlantic and along the California coastline. The disease was first described in the red sea urchin (Mesocentrotus franciscanus)[1].

Research suggests two pathogens are responsible for the disease, Listonella anguillarum and Aeromonas salmonicida[2].

Infection generally occurs at the site of an existing physical injury. The affected area turns green and spines and other appendages are lost. Urchins also lose control of their tube feet, which they use to walk.

Spine loss is the key characteristic of the disease. If the lesion remains shallow and covers less than 30% of the animal's surface area, the animal tends to survive and eventually regenerates any lost tissue. However, if the damage is more extensive or so deep that the hard inner test is perforated, the disease is fatal.

In the 1980s the near disappearance of a keystone herbivore, the long-spined black sea urchin (Diadema antillarum) due to disease of unknown etiology resulted in a massive ecological phase shift in the Caribbean Sea from coral cover to uncontrolled algal growth on the reefs.

At the beginning of 2023, researchers spotted the first signs of the urchin plague in the Mediterranean Sea, when an invasive species of urchin, the black sea urchin (Diadema setosum), began falling sick in waters around Greece and Turkey. From there, the disease appears to have spread southward through the Suez Canal to the Red Sea.

The epidemic looks set to wipe out all of the Mediterranean and Red Sea’s urchins, and possibly their coral reefs too.

"It's a fast and violent death: within just two days a healthy sea urchin becomes a skeleton with massive tissue loss," Omri Bronstein, a senior lecturer in Zoology at Tel Aviv University, said in a statement. "While some corpses are washed ashore, most sea urchins are devoured while they are dying and unable to defend themselves, which could speed up contagion by the fish who prey on them."

It is unknown why sea urchins are suddenly vulnerable to these bacterial predators. Maybe it is a result of climate change or maybe one of these bacteria mutated and shared some mutated genes with another bacterial species.

[1] Johnson: Studies on Diseased Urchins from Point Loma in Annual Report Kelp Habitat Improvement Project – 1971
[2] Shaw et al: Bald sea urchin disease shifts the surface microbiome on purple sea urchins in an aquarium in Pathogens and disease – 2023. See here.

Wild Boar Paradox

On April 26, 1986, the Number Four RBMK reactor at the nuclear power plant at Chernobyl, Ukraine, went out of control during a test at low-power, leading to an explosion and fire that demolished the reactor building and released large amounts of radiation into the atmosphere.

The explosion had a major impact on the forest ecosystem in Central Europe. While the contamination of deer and roe deer decreased over time as expected, the measured levels of radioactivity in the meat of wild boar remained almost constant. The limit values are still being exceeded by a significant margin in some samples. For years, this Wild Boar Paradox was considered unsolved. Until now[1].

To identify the source of radioactive caesium in Bavarian wild boar meat, the scientists turned to a different caesium isotope with a much longer half-life: ₁₃₅Cs. A nuclear explosion yields a relatively high ₁₃₅Cs/₁₃₇Cs-ratio, whereas a reactor yields a low ratio.

After analysing the ratio of Caesium isotopes in samples of wild boar meat from eleven districts of Bavaria, Germany, scientists concluded that global fallout from nuclear weapons tests is still responsible for a significant fraction of the contamination, even though Bavaria also experienced heavy fallout from the Chornobyl reactor meltdown.

Although Chernobyl has been widely believed to be the prime source of ₁₃₇Cs in wild boars, the team found that “old” ₁₃₇Cs from weapons fallout significantly contributes to the total level (10–68%) in those specimens that exceeded the regulatory limit. 

In the paper, scientists note that this paradoxical non-decline is often attributed to the boars’ tendency to root up and eat underground fungi such as deer truffles. Under the 'right' soil conditions, these organisms act as a repository for ₁₃₇Cs, which migrates downwards through the soil very slowly, sometimes only about one millimetre per year.

This result suggests that there are, in effect, two separate downward-migrating Caesium “fronts” contaminating the boars’ winter food supply: one from atmospheric nuclear weapons tests, which peaked in 1964, and one from Chernobyl in 1986.

[1] Stäger et al: Disproportionately High Contributions of 60 Year Old Weapons-137Cs Explain the Persistence of Radioactive Contamination in Bavarian Wild Boars in Environmental Science & Technology – 2023. See here.

Flight Shame (or Flygskam)

Like Greta Thunberg, flight shame (or flygskam) is an anti-flying social movement that originated in Sweden. The aim of this movement is to reduce the environmental impact of aviation.

Flight shame refers to an individual's uneasiness over engaging in activities that are energy-intense and climatically problematic. The movement started in 2018 in Sweden and gained some traction the following years among climate activists throughout northern Europe. The term is also used to shame air travelers as people involved in socially undesirable activities. This way the movement tries to discourage people from flying to lower carbon emissions in order to thwart climate change.

Staffan Lindberg, a Swedish singer, was reported to have coined the term flygskam in 2017. Malena Ernman, a Swedish opera singer and the mother of climate activist Greta Thunberg, also announced publicly that she would stop flying. She was blackmailed into flygskam by her daughter, because forr about two years, Greta Thunberg challenged her parents to lower the family's carbon footprint and overall impact on the environment by becoming vegan, upcycling, and giving up flying[1].

Tågskryt, a Swedish word that literally means 'train brag', is a term that is also derived from the flygskam movement. It wasn't enough just to shame people, but you also had to brag that you were better than them. Yes, you have to post your journey by train on social media.

But, as we are all humans, some claim to be part of the flygskam movement, but do take the occasional flight. The Swedish call this att smygflyga (to sneakily fly) and no one will ever post this on social media.

While the intentions of the adherents of flygskam are perhaps laudable, their impact is minimal. In fact, shaming people into not using a plane is probably counterproductive. As are Greta Thunberg's actions. Have you ever wondered how Greta Thunberg travels to all those locations to participate in strikes?

[1] Jonathan Watts: Greta Thunberg, schoolgirl climate change warrior: ‘Some people can let things go. I can’t’ in The Guardian - March 11, 2019. See here.

Lost Key Syndrome

The official designation of the Lost Key Syndrome is Dysexecutive Syndrome. It consists cf a group of symptoms, usually resulting from brain damage to the frontal lobe. The syndrome describes a common pattern of dysfunction in functions, such as planning, abstract thinking, flexibility and behavioural control. Although many of the symptoms regularly co-occur, it is common to encounter patients who have several, but not all symptoms.

Patients are left wondering whether these symptoms are the result of their brain injury, whether they are just a result of the patient is getting older, or whether they simply lost their keys for the umpteenth time.

These symptoms that fall into cognitive, behavioural and emotional categories and tend to occur together. Many of the symptoms can be seen as a direct result of impairment to the central executive component of working memory, which is responsible for attentional control and inhibition.

The Lost Key Syndrome often seems to occur with other disorders, such as schizophrenia, dementia, Alzheimer's disease, meningitis and chronic alcoholism[1].

Assessment of patients with the Lost Key Syndrome can be difficult because traditional tests generally focus on one specific problem for a short period of time. People with Lost Key Syndrome can do fairly well on these tests because their problems are related to integrating individual skills into everyday tasks. The lack of everyday application of traditional tests is known as low ecological validity.

There is no cure for individuals with the Lost Key Syndrome, but there are several therapies to help them cope with their symptoms in everyday life.

[1] Abbruzzese et al: Persistent dysexecutive syndrome after pneumococcal meningitis complicated by recurrent ischemic strokes: A case report in World Journal of Clinical Diseases - 2023

Female Inconsistency Syndrome

The Female Inconsistency Syndrome describes a very specific type of character, known as Mary Sue.

A Mary Sue is a character archetype in fiction, usually a young woman, who is often portrayed as inexplicably competent across all domains, gifted with unique talents or powers, liked or respected by most other characters, unrealistically free of weaknesses, extremely attractive, innately virtuous, and/or generally lacking meaningful character flaws[1].

[Batgirl and the actress who played her]

Mostly, she is a slim and beautiful young woman. If a Mary Sue hits a grown man weighing about 100 kilograms, he will fall down like he's been hit by a 10-ton truck.

As a literary trope, the Mary Sue archetype is broadly associated with poor-quality writing, and stories featuring a Mary Sue character are often considered weaker for it. Though the term is mostly used negatively, it is occasionally used positively.

Always female and almost always the main character, a Mary Sue is often an author's idealized self-insertion and may serve as a form of wish fulfillment. Mary Sue stories are often written by adolescent authors or adults who didn't grow out of their adolescence[2].

There's a syndrome lurking beneath that childish writing. Why would a grown man write about a fictional and idealized woman who has no flaws? In this divisive world where 'woke' is equivalent to 'broke', such a unnatural depiction of women will drive away the public that simply wants to watch a movie to be entertained. 

[1] Framke: What is a Mary Sue, and does Star Wars: The Force Awakens have one? in Vox - 2015. See here.
[2] Whatsawhizzer: The Mary Sue and Female Inconsistency Syndrome in wattpad. See here.

Hypochondria Paradox

Once called hypochondriasis, it has now a new designation: illness anxiety disorder. It was added as a separate disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013. It is a rare condition with symptoms that go beyond average health worries.

Symptoms include a ersistent anxiety or fear of developing or having a serious medical illness that adversely affects their daily life. This fear persists despite normal physical examination and laboratory testing results. Patients pay excessive attention to normal bodily sensations (such as functions of digestion or sweating) and misinterpret these sensations as indicators of severe disease[1]. Some may change doctors repeatedly. Others may avoid medical care.

Many of us are mild hypochondriacs. But there are also people on the other extreme of the spectrum who live in a perpetual state of worry and suffering and rumination about having a serious illness.

A large Swedish study has uncovered a paradox about people diagnosed with an excessive fear of serious illness: They tend to die earlier than people who aren’t hypervigilant about health concerns[2].

Older research had suggested the risk of suicide might be lower for people with the condition, but according to data in the new study, the risk of suicide was in fact four times higher for the people with the diagnosis.

Researchers looked at 4,100 people diagnosed with hypochondriasis and matched them with 41,000 people similar in age, sex and county of residence. They used a measurement called person years, which accounts for the number of people and how long they were tracked.

The researchers found that people with the diagnosis have an increased risk of death from both natural and unnatural causes, particularly suicide. Chronic stress and its impact on the body could explain some of the difference, the authors wrote.

The Hypochondria Paradox is therefore: The more you worry about dying early, the earlier you die.


[1] French, Hameed: Illness Anxiety Disorder in StatPearls – 2023. See here.
[2] David Mataix-Cols et al: All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis in JAMA Psychiatry – 2023. See here.

Newyorkitis

Newyorkitis is an affliction generally seen in people living in New York, and especially in Manhattan. It was first described by surgeon John H. Girdner describing "a condition of mind, body, and soul" that he had observed among patients living in the New York City borough of Manhattan[1].

John H. Girdner (1856-1933) was a prominent New York surgeon. He taught at medical schools and was the author of numerous satirical and philosophical articles for magazines.

Girdner ascribed a variety of physical symptoms to living in Manhattan, including nearsightedness (caused by the presence of buildings in all directions), irritated hearing (irritated by constant noise), and a "rapidity and nervousness and lack of deliberation in all muscular movements." Other symptoms included "haste, rudeness, restlessness, arrogance, contemptuousness, excitability, anxiety, pursuit of novelty and of grandeur, pretensions of omniscience, and therefore prescience, which of course undermines any pleasure taken in novelty."

Yes, Newyorkitis was described as "satirical" in obituaries at the time of Girdner's death, and in reviews at the time of publication of his book 'Newyorkitis' in 1901, but time has been kind to Girdner.

A 2020 article observed that at the time, the press "saw evidence of Girdner’s syndrome everywhere."[2] A New York Tribune article on Newyorkitis reported in 1905 that “there were three thousand cases of men falling dead or dying suddenly, an increase of five hundred over any previous year. The pace of the average New Yorker,” the article concluded, “is not only too fast, it is deadly.” In 1908, the Tribune reported that treatment for the condition was being offered at a New York YMCA. It was described as "straight psychology applied directly to the abnormal conditions of urban business and social life."

The stressor was already seen in the Victorian Age in Britain. The advent of steam powered machines added an urgency to everyday life that was previously unknown. Add to this the poverty, pollution, and disease that pervaded the crowded cities, and you will understand the effect it all had on the Victorian minds[3].

[1] Girdner: Newyorkitis – 1901
[2] Charlee Dyroff: An Inflammation of Place: On the symptoms and spread of Newyorkitis in Lapham's Quarterly – 2020. See here.
[3] Fred de Vries: The fear of cats in Victorian times – 2017. See here.

Parental Alienation Syndrome

Getting divorced is never a happy occasion, but responsible parents always want to make sure that their children suffer as little as possible. Using your children as a weapon to get back at your ex-spouse is the vilest thing a parent can do.

Enter the Parental Alienation Syndrome, a term introduced by child psychiatrist Richard Gardner in 1985 to describe signs and symptoms he believed to be exhibited by children who have been alienated from one parent through manipulation by the other parent, usually in the context of child custody disputes[1].

Gardner describes the syndrome as follows: A childhood disorder that arises almost exclusively in the context of disputes over child custody. Its primary manifestation is the child's campaign of denigration against a parent, a campaign without justification. This results from the combination of programming (brainwashing) due to parental indoctrination and the child's own contributions to the vilification of the target parent. When physical or sexual abuse is present, animosity may be justified, and so the explanation of the child's hostility as parental alienation syndrome is inapplicable.

Gardner believed that a set of behaviours that he observed in some families involved in child custody litigation could be used to diagnose psychological manipulation or undue influence of a child by a parent, typically by the other parent who may be attempting to prevent an ongoing relationship between a child and other family members after family separation or divorce.

Proposed symptoms included extreme but unwarranted fear, and disrespect or hostility towards a parent.

The perpetrator may - deliberately or unconsciously - use a variety of tactics to indoctrinate: one parent could tell a child that the other parent hates him and never wants to speak to them, when in reality that parent calls (or tries to call) to speak to the child virtually every day but is refused to do so. A mother might try to convince her daughter to believe and to report to the authorities that the father verbally, physically or sexually abused her. Offenders may blame the other parent for the collapse of the marriage, punish the child for wanting to pursue a relationship with the parent, or move far away so that maintaining a relationship is extremely difficult[2].

Use of the term 'Syndrome' has not generally been accepted by either the medical or legal communities and research has been broadly criticized for lacking scientific validity and reliability. Still, it is a vile abuse of children with potential long lasting effects.

[1] Gardner: Recent trends in divorce and custody litigation in Academy Forum - 1985
[2] Clemente, Padilla-Racero: Are children susceptible to manipulation? The best interest of children and their testimony in Children and Youth Services Review – 2015.

Autumn Sneezing Syndrome

Hay fever is a seasonal type of allergic rhinitis. It is a type of inflammation in the nose that occurs when the immune system overreacts to environmental allergens in the air, such as pollen.

Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes.

Until recently, hay fever was limited to spring, summer, and early fall. That's logical, because those are the periods in which plants release their pollen for the purpose of sexual reproduction.

But nowadays, autumn allergies are becoming more common. This phenomenon, called Autumn Sneezing Syndrome, is said to be caused by changing pollen patterns as well as an invasive family of plants called ragweeds (Ambrosia). A single plant may produce about a billion grains of pollen per season. Ragweed pollen can remain airborne for days and travel great distances, and can even be carried over 500 kilometers.

Ragweeds, native to the Americas, have been introduced to Europe in the nineteenth century and especially during World War I, and have spread rapidly since the 1950s.

'Usually you get hay fever starting with the tree pollen in March and April and then grass pollen from May to August, then that was the end of it for most people,' said Dr Adrian Morris, principal allergist at Surrey Allergy Clinic (UK).

Dr Morris said the number of people affected was increasing, in part, due to allergic reactions caused by ragweed, which sheds its pollen later in the year than most plants.

The major allergenic compound in the pollen has been identified as Amb a 1, a 38 kDa nonglycosylated protein composed of two subunits. It also contains other allergenic components, such as profilin and calcium-binding proteins[1].

However, Dr Morris said the main reason why such a large amount of people were continuing to experience allergies long after the summer months was still unclear, emphasising it was a 'reasonably new phenomenon'.

[1] Wopfner et al: The spectrum of allergens in ragweed and mugwort pollen in International Archives of Allergy and Immunology – 2005

Fish Odour Syndrome

If your doctor decides you are afflicted with Fish Odour Syndrome, he might soften the blow by claiming you have a condition called Trimethylaminuria.

The symptoms of Fish Odour Syndrome can be present from birth, but they may not start until later in life, often around puberty. That smell may be constant or may come and go.

The only symptom is that you emit an unpleasant smell, typically of rotting fish – although some might describe it as smelling like other smelly things – that can affect your breath, sweat, urine, and vaginal fluids.

In the Fish Odour Syndrome, the body is unable to turn a strong-smelling chemical called trimethylamine – produced in the gut when bacteria break down certain foods – into a different chemical that doesn't smell. This means trimethylamine builds up in the body and gets into bodily fluids like sweat. That particular sweaty condition is also called Bromhidrosis.

The problem lies in a faulty gene, the FMO3 gene. It provides instructions for making an enzyme that is part of a larger enzyme family called flavin-containing dimethylaniline monooxygenases (FMOs). These enzymes break down compounds that contain nitrogen, sulfur, or phosphorus. The FMO3 enzyme, which is made chiefly in the liver, is responsible for breaking down nitrogen-containing compounds derived from the diet.

Things that can make it worse include sweating, stress, periods and certain foods – such as fish, eggs, and beans.

The Fish Odour Syndrome is probably caused by one or more faulty genes that a person inherits from their parents, but this isn't always the case.

There's currently no cure. Patients are advised to avoid choline-rich foods and take hygienic measures[1].

[1] Kloster, Erichsen: Trimethylaminuria in Tidsskrift for den Norske lægeforening - 2021

Olfactory Reference Syndrome

Olfactory Reference Syndrome is characterized by a distressing or impairing belief by a person that they emit a foul or offensive body odour. The odour is imagined, slight or imperceptible to others[1].

Patients with Olfactory Reference Syndrome are preoccupied, usually for many hours a day, with a distressing or impairing belief that they emit one or more foul or offensive body odours, which are not perceived by others or are actually only slight. They may believe, for example, that they have very bad breath or emit foul-smelling sweat from their armpits or other areas of their skin. Other worries include emitting a smell of urine, flatulence, or unpleasant odours from the genital area. Occasionally, patients believe that they emit odours like old cheese, garbage or rotten food.

The preoccupation with body odour is usually accompanied by repetitive bahaviours, such as smelling themselves, excessive showering, changing clothes and/or reassurance seeking. These behaviours attempt to alleviate the substantial distress caused by the preoccupation with body odour. Most people with Olfactory Reference Syndrome also make efforts to camouflage the perceived odour, for instance with perfume, deodorant, mouthwash and/or bubblegum.

This disorder often results in shame, embarrassment, significant distress, avoidance behaviour, social phobia, and social isolation.

Insight is usually poor or absent. Very few recognize that their belief about the body odour is inaccurate. Thus many patients hope to find treatment to aleviate their problems, such as tonsillectomy for perceived halitosis, proctectomy (anus removal) for perceived anal/flatulence odour.

Cases have been reported from around the world. It is difficult to estimate the prevalence of this condition because data is limited and unreliable. Males appear to be affected twice as commonly as females.

Olfactory Reference Syndrome shares clinical features of both Obsessive-Compulsive Disorder and Social Anxiety Disorder[2]. This suggests that the comorbidity of Obsessive-Compulsive Disorder and Social Anxiety Disorder most likely explains the development of Olfactory Reference Syndrome.

There is no agreed treatment for Olfactory Reference Syndrome. Treatment often includes antidepressants, followed by antipsychotics, and various psychotherapies. Antidepressants seem to be more helpful than antipsychotics.

[1] Phillips, Menard W: Olfactory reference syndrome: Demographic and clinical features of imagined body odour in General Hospital Psychiatry - 2011
[2] Tada: Olfactory Reference Syndrome: Its Relationship to Comorbidity of Social Anxiety Disorder and Obsessive-Compulsive Disorder in Journal of Nervous and Mental Disease - 2023

Neuroleptic Malignant Syndrome

Suppose you need to be prescribed antipsychotic drugs. You (or your loved ones) obviously hope that these drugs will have the desired effect. But for some, an even worse fate than a psychosis lies dormant.

Neuroleptic malignant syndrome is a potentially life-threatening idiosyncratic reaction to antipsychotic drugs characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction[1]. ‌The fever might result in hyperpyrexia, a condition where the body temperature goes above 41.5^o Celsius due to changes in the hypothalamus, the organ in the brain that regulates temperature.‌

The syndrome has been associated with virtually all neuroleptic drugs, including newer atypical antipsychotics, as well as a variety of other medications that affect central dopaminergic neurotransmission.

The first reported case of Neuroleptic Malignant Syndrome appeared in 1956, shortly after the introduction of the antipsychotic drug chlorpromazine (thorazine), which is primarily used to treat psychiatric disorders such as schizophrenia[2]. In the 60s, the medical world became increasingly worried and case studies started to appear regularly in journals[3].

Although uncommon, Neuroleptic Malignant Syndrome remains a critical consideration in the differential diagnosis of patients presenting with fever and mental status changes because it requires prompt recognition to prevent significant morbidity and death.

Treatment includes immediately stopping the offending drug and implementing supportive measures, as well as pharmacological interventions in more severe cases. Maintaining vigilant awareness of the clinical features of Neuroleptic Malignant Syndrome to diagnose and treat the disorder early, however, remains the most important strategy.

[1] Berman: Neuroleptic Malignant Syndrome in The Neurohospitalist – 2011
[2] Ayd: Fatal hyperpyrexia during chlorpromazine therapy in Journal of Clinical and Experimental Psychopathology – 1956
[3] Delay et al: Neuroleptique majeur non phénothiazine et non réserpine, l'halopéridol, dans le traitement des psychoses in Annales Médico-Psychologiques (Paris) - 1960

Great Sheep Panics

The Great Sheep Panic is also known as the 'Great Sheep Panic of 1888' or the 'Mysterious Oxfordshire Sheep Panic of 1888'. It was an event that occurred on 3 November 1888 across southern England, when tens of thousands of sheep fled from various fields across some 520 square kilometers of Oxfordshire.

On the evening of 3 November 1888, at around eight o'clock, thousands of sheep had, supposedly by a simultaneous impulse, burst from their bonds, fields, and dwellings. They had been found the next morning, widely scattered, some of them still panting with terror under hedges, and many crowded into corners of fields, some miles from the fields they had been left in the previous evening.

The Times reported on 20 November 1888 that "malicious mischief was out of the question because a thousand men could not have frightened and released all these sheep." Interestingly, another panic occurred in 1889, in Berkshire (southern England), not far from Reading. Again, on the night of December 4, 1893, another very remarkable panic among sheep occurred in the northern and middle parts of Oxfordshire, extending into adjoining parts of the counties of Warwickshire, Gloucestershire, and Berkshire.

The heavy, oppressive atmosphere accompanying the thick darkness, the susceptibility of sheep to atmospheric disturbances, and their nervous and timid dispositions would all tend to increase the fright the sheep experienced. The cause of the panic being a cloud rolling along so low down as (apparently) to touch the ground, the tops of the hills and the highlying ground would naturally be most affected; and this is observed to be the case, although locally the usual direction followed by thunderstorms has indicated a line along which sheep stampeded on nearly every farm[1].

[1] Author unknown: Sheep panic in Nature - 1921

Galileo Syndrome

The Galileo Syndrome is also called the Galileo Fallacy, and is best known for its use by conspiracy theorists and anti-vax adherents.

The Galileo Syndrome is a logical fallacy that asserts that if your ideas provoke the establishment to supposedly vilify or threaten you, then you must be right — "everyone says I am wrong, therefore I am right."

It is not known if Galileo Galileo (1564-1642) actually expressed those words in Latin (Omnes, inquit, Fallor, ergo recte). Better known is his E pur si muove ('and yet it moves') uttered in 1633 after being forced to recant his claims that the Earth moves around the Sun, rather than the opposite.

Stupid people use this argument too often in response to serious criticisms on their views on a subject that they simply don't understand. What proponents of this fallacy fail to understand is that not all people who challenge the mainstream scientific consensus are martyrs or revolutionaries: in most cases, they are just simply idiots.

Another, closely related quote is 'First They Ignore You, Then They Ridicule You, Then They Fight You, Then You Win'.

This quote is invariably misattributed to Mahatma Gandhi (1869-1948) and proudly repeated like a mantra by complete idiots who think that their idea of science must be more true than that of a scientist who spent his entire working life to understand his chosen field.

Delving deep into history we find the first version of this misattributed quote in 1914 in a speech by the American labour union leader Nicholas Klein when he says 'And, my friends, in this story you have a history of this entire movement. First they ignore you. Then they ridicule you. And then they attack you and want to burn you. And then they build monuments to you. And that, is what is going to happen to the Amalgamated Clothing Workers of America'.

Selective Sound Sensitivity Syndrome

Selective Sound Sensitivity Syndrome is also known as misophonia or sound-rage. It is a disorder of decreased tolerance to specific sounds or their associated stimuli, or cues. These cues, known as "triggers", are experienced as unpleasant or distressing and tend to evoke strong negative emotional, physiological, and behavioral responses that are not seen in most other people.

Negative reactions to these trigger sounds range from annoyance to anger, with possible activation of the fight-or-flight response. The responses do not seem to be elicited by the loudness of the sound, but rather by its specific pattern or meaning to the hearer. Triggers are commonly repetitive stimuli and are primarily, but not exclusively, related to the human body, such as chewing, eating, smacking lips, slurping, coughing, throat clearing, sniffing, and swallowing.

Once a trigger stimulus is detected, people with Selective Sound Sensitivity Syndrome may have difficulty distracting themselves from the stimulus, and may experience suffering, distress, and/or impairment in social, occupational, or academic functioning.

The expression of symptoms varies, as does the severity, which ranges from mild (anxiety, discomfort, and/or disgust) to severe (rage, anger, hatred, panic, fear, and/or emotional distress). Some people with Selective Sound Sensitivity Syndrome are aware that their reactions triggers are disproportionate to the circumstances.

Symptoms are typically first observed in childhood or early adolescence. Selective Sound Sensitivity Syndrome is probably a symptomatic manifestation of an underlying (other) psychiatric disorder, including mood disorders, anxiety disorders, ADHD, OCD, depressive disorders, and autism[1][2]. Its mechanism is also not yet fully understood, but it appears that it may be caused by a dysfunction of the central nervous system in the brain.

In 2022, clinical and scientific leaders convened to create a consensus definition of Selective Sound Sensitivity Syndrome agreeing that it is a disorder of decreased tolerance to specific sounds and their associated stimuli[3].

Health care providers generally try to help people cope with misophonia by recognizing what the person is experiencing and working on coping strategies.

[1] Cavanna, Seri: Misophonia: current perspectives in Neuropsychiatric Disease and Treatment – 2015. See here.
[2] Guzick et al: Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia in Journal of Affective Disorders – 2023. See here.
[3] Swedo et al: Consensus Definition of Misophonia: A Delphi Study in Frontiers in Neuroscience – 2022. See here.