The excellent article by Robinson and colleagues1 in this issue of the Archives reminds us that mass hysteria is not infrequently encountered among groups including women or girls in close personal association and experiencing stress. Schools and work places are recognized as illness-producing settings. While a diagnosis is usually made by excluding infectious, allergic, and toxic causes, a number of characteristics should suggest epidemic hysteria, even in the hospital emergency room.
Outbreaks are often explosive, frequently affecting an entire group of susceptibles within a few minutes. The disease usually spreads from person to
See also p 1959. person after unaffected individuals have had the opportunity to observe the symptoms of an ill person. When the population at risk includes both sexes, women and girls typically are affected more frequently and more severely than men and boys. Incidents involving only male subjects are extremely uncommon. The paucity of physical findings contrasts