Mass hysteria: one syndrome or two?

BACKGROUND: It has been suggested that mass hysteria can be divided into two syndromes; one with predominant features of anxiety and the other with predominant abnormalities of motor behaviour. In the former condition, prior tension is absent and spread is by visual contact. In the latter, prior tension is present, initial cases can be identified and spread is gradual. METHOD: The development and resolution of neurological symptoms in 156 Nigerian school girls were studied and a diagnosis of 'mass hysteria' made. RESULTS: The signs and symptoms manifested by the school girls during the outbreak of illness had features of both 'anxiety' and 'motor' predominant forms of mass hysteria. CONCLUSIONS: Although there may be two patterns of symptom presentation in mass hysteria, other supposedly discrete features overlap. This weakens the argument that there are two separate syndromes.