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Unique Neurosis Grips Yugoslav Coastal Area In areas of Istria, Yugoslavia, "that let-down feeling" may be more real than anywhere else in the world. A unique neurosis grips the people who inhabit the coast of this peninsula on the Adriatic Sea, says Dr. Marcia Cooper, associate professor of emergency mental hygiene in the Johns Hopkins School of Public Health. Many have "debolezza," which causes them to fall down and give them a general feeling of weakness and depression. They may also have severe gastric pain, skin lesions, and anemia. The condition is marked by deficiency of vitamin B6, pyridoxin. Of 286 rural villagers studied, 49 men and 90 women had debolezza. Women have increased fetal wastage and a later age at menarche - about age 15-1/2 compared to the usual age of 14. The condition may be metabolic and genetically controlled rather than simply nutritional. The villages in the study all bear the name of the predominant family. For example, in the village of Močibobi, 53 percent of the people examined had that name. Sometimes both parents have the same last name, which also points to a genetic factor. The people are poor farmers whose diet is almost entirely starch. They sell rather than consume the pyridoxin-rich chickens and eggs which might improve their nutrition. The people look depressed, move slowly, complain of headaches and fierce stomach pains, and express their limb weakness in a gesture of complete collapse of their arms. Their ability to work is impaired because the weakness is present most of the time, according to Dr. Cooper. Psychiatric evaluation revealed that depression is frequently present. It is possibly a depressive neurosis or a depressive neurasthenia, or it might be just depression, Dr. Cooper says. The people seek treatment frequently so that an overwhelming 92 pecent of the total adult population responded to the request of their health officer to come for evaluation. But because funds were limited, no pyridoxin tablets were given, although they might have helped those with a genetic basis for the deficiency. The condition is so far uniquely described in Yugoslavia but may also exist in some animals, whose poor coats could correspond to skin with lesions in humans. But whether the animals are also depressed is unknown. Interestingly, the coastal water supply is "buvanda," rainwater caught as it pours from the church roof. It is laced with wine, and even the children drink it. Some water is caught in underground vats. There are no wells because the porous limestone permits ground water to seep through into large underground streams. Inland Istrians are not familiar wiht the condition, and Yugoslavs are usually taller than the short-statured coastal Istrians, Dr. Cooper notes. The debolezza research ranks in interest with Dr. Cooper's earlier studies of Baltimoreans with pica, persons who had eaten soil to improve their health. Nutrients such as iron in red clay, calcium in paint, and salt are obtained by simply eating the proper material. Sometimes the clay is baked in small loaves and chipped off when desired. One woman in the study made regular trips to the Baltimore brickyard to obtain a bag of refined clay, which was eaten by several members of the household. The practice may be acquired by observing it in others. It has also been attributed to innate instinct or to homesickness. In the study, more blacks than whites had pica. Black women are more likely to be anemic. The condition is often manifested in pregnancy accompanied by anemia. People with pica are not always poor, but usually their diet is primarily carbohydrate. It is normal in a sense to seek the thing in which you are deficient, Dr. Cooper says. However, viewed differently, pica is abnormal. Worms, yaws, and sclerosis with pregnancy are sometimes noted accompaniments. During pregnancy, some women eat considerable quantities of clay but no longer crave it after delivery. Sometimes dry laundry starch is substituted to allay the craving, but starch doesn't contain the iron that the clay might. The eating of edible earths by domesticated animals is a common feature of animal husbandry. Source:
Related article: "Deboleza: Culturally Determined Behavior in Istria", PSYCHOPATHOLOGY, Vol. 30, No. 4, 1997, p. 215-222. Pavlotic, E. and Vucic, M. (Rijeka). Psychiatric Clinic of Rijeka, Croatia. Deboleza is a behavioural construct among the inhabitants of Istria (a peninsula in the Adriatic Sea which belongs mainly to Croatia); it has peculiar social, ethno-psychological and historical characteristics because it is a relatively small region which has been the intersection of various cultures and civilizations. In this research the concept is analysed from the psychomedical point of view. As deboleza does not have the status of an illness, it functions as a culture-bound syndrome which, because of its emotional expressions, belongs to the 'shame' family. This interesting construct should be thoroughly studied not only in a peculiar and dynamic Croatian culture and in Croatian psychiatry, but also within European culture and psychiatry. |
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This page compliments of Marisa Ciceran Created: Wednesday, August 11, 1999; Last Updated:
Tuesday, May 10, 2011 |
