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Abstract
Running amok is considered a rare culture-bound syndrome by current psychiatric classification systems, but there is evidence that it occurs frequently in modern industrialized societies. The historical origins of running amok as a psychiatric condition are reviewed in this article, and its relevance to modern day episodes of violent behavior is discussed. Psychotic illnesses, personality disorders, and mood disorders are all possible causes of amok, and the identification and treatment of patients who are at risk for manifesting violent behavior are discussed.
The general public and the medical profession are familiar with the term running amok, the common usage of which refers to an irrational-acting individual who causes havoc. The term also describes the homicidal and subsequent suicidal behavior of mentally unstable individuals that results in multiple fatalities and injuries to others. Except for psychiatrists, few in the medical community realize that running amok is a bona fide, albeit antiquated, psychiatric condition. Although episodes of multiple homicides and suicide by individuals with presumed or known mental disorders occur with alarming regularity today, there are virtually no recent discussions in the medical literature about the recognition and treatment of these individuals before their suicidal and homicidal behavior occurs.
The psychiatric literature classifies amok as a culture-bound syndrome based on its discovery 2 centuries ago in remote primitive island tribes where culture was considered the predominant factor in its pathogenesis. The primitive groups' geographic isolation and spiritual beliefs were thought to produce a mental illness not observed elsewhere in the world. DSM-IV,1 which is the current consensus opinion on psychiatric diagnosis, depicts amok as a cultural phenomenon that rarely occurs today. However, characterizing amok as a culture-bound syndrome ignores the fact that similar behavior has been observed in virtually all Western and Eastern cultures, having no geographical isolation. Furthermore, the belief that amok rarely occurs today is contrary to evidence that similar episodes of violent behavior are more common in modern societies than they were in the primitive cultures where amok was first observed.
