Complaints are found in 34% of patients.

The review suggested that dissociative

trance disorder is a widespread disorder that can be understood as a global idom of
distress. It is probably underdiagnosed in western countries owing to cultural biases.
In this case, we should avoid the assumption that the western variants of disorders
are somehow “purer” and “less culturebound” than those that occur in other cultures.
In some cases it may be the western from of a disorders that is best seen as a mere
variant of a more universal category.
Possession disorders are commonly reported in indian general population
(3,7%)(venkataramiah et al, 1981) based on data derived from clinical records over
a l-ycar priod, srinath et al (1993) reported the prevalence of hysteria to be 30.8% in
inpatient and 14.8% in the outpatient samples from a centre in south india. The
inpatients with hysteria-were mostly postpubertal, their gender distribution was
approximately even, and pseudo-seizure was the most frequent presentation. These
short-term outcome was generally positive. In a similar study from north india, sethi
et al (2010) found that 12,5% of children received the ICD-10 diagnosis of
aissociative (conversion) disorders with dissociative convulsions being the most
common. Just over half of the subjects were girls in the adolescent age group, and a
similar proportion had an illness of acute onset. About 90% of the subjects reported
one or more significant psychosocial stressor and a similar proportion remitted with
dissociative disorders. Follow up over 18 months revealed that most of the remained
symptom free and were functioning well at school. The data suggests bias in
recognition of specific syndromes found in developing countries in DSM-5(Jacob et
al, 2013)
Brain fag syndrome (BFS)
Brain fag was originally described by Raymond prince (1960). The patients were
mostly students in secondary school or university, or teachers or government clerks
who were studying in their space time to raise their educational levels. Prince noted
that, in Nigeria, education was associated with family prestige and possibility of
economic advancemen. The patients generally attributed their illnesses to fatigue of
the brain due to excessive mental work. The main clinical feactures of BES include
unpleasant head and neck symtomps such as pain, burning and crawling sensations;
visual disturbances of dimmed vision, pain and tearfulness in the eyes; cognitive
impairments such as inability to concentrate, poor retention and inability to graps
the meaning of written or spoken words. Other symptoms are body weakness,
burning ar nigrating pains(aina and morakiny, 2011)
BFS is a common condition among students ( rate varying from 25% -58%) and is
much commoner in males (Prince,1989). Subjects with BFS tend to score high on
the neuroticism scale of the Eysenck personality inventory (EPI), have a figh
achievement orientation, come from economically deprived social background,
suffer from sleep deprivation during intensive study for examination, and at times
use amphetamines or strong coffee to keep awake (Morakinyo, 1980) Jegede (1983)
pointed out the overlap with anxiety and depressive disorders and reported its
successful treatment with antidepressant drugs. The management of BFS includes
the use of antidepressant and/ or anxiolytics along with supportive therapy, cognitive
therapy or relaxation.
Brain fag is now known to be prevent among students all over sub-saharan Africa
(tseng, 2006). An instrument, the brain fag syndrome scale (BFSS) is now in
existence for the detection and measurement of the intensity of the syndrome.
Mal de ojo
This syndrome has been described in western Africa. Children are especially at risk,
if they are beautiful and robust. It is believed to be caused by the strong sight of
some individuals arising from envy (in urdu we would call it nazar lagna). The
symptoms include vomiting, diarrhea, crying, and restlessness. Some individuals are
believed to be more adept at causing this syndrome. They include pregnant women,
irate, and druken individuals ( Berganza et al, 2001).