Rare and Unusual Psychiatric Syndromes: A Primer

Christoph U. Correll, MD; Bret S. Stetka, MD; Ariel Harsinay

Disclosures

July 23, 2018

Lima Syndrome

Lima syndrome is the exact inverse of Stockholm syndrome. In this case, hostage-takers or victimizers become sympathetic to the wishes and needs of the hostages or victims. The name comes from a 1996 Japanese embassy hostage crisis in Lima, Peru. Fourteen members of the Túpac Amaru Revolutionary Movement took several hundred diplomats, government and military officials, and business executives of many countries hostage at a party that took place at the official residence of Japan's ambassador to Peru. Curiously, within a few days of the hostage crisis, the militants had released most of the captives, with seeming disregard for their importance, including the future president of Peru and the mother of the current president. After months of unsuccessful negotiations, all remaining hostages were freed by a raid by Peruvian commandos, although one hostage was killed. It is unclear whether Lima syndrome can be explained by feelings of guilt, moral indecisiveness, second-guessing of one's actions, or obliviousness.

Stendhal Syndrome

Stendhal syndrome is characterized by physical and emotional anxiety up to the level of a panic attack, dissociative experiences, confusion, and even hallucinations when an individual is exposed to art. The syndrome is usually triggered by art that is perceived as particularly beautiful, or when the individual is exposed to large quantities of art that are concentrated in a single place. The term can also be applied to a similar reaction to other overwhelming experiences, for example when confronted with immense beauty in the natural world.

Stendhal syndrome is named after the 19th-century French author Stendhal who described his experience with the phenomenon during his visit to Florence, Italy, in 1817, when he was 34 years old. It has also been called "hyperculturemia" or "Florence syndrome."

Usually, Stendhal syndrome is self-limited and not followed by lasting or severe mental sequelae, and no interventions beyond supportive measures are needed.

Diogenes Syndrome

Diogenes syndrome is a condition characterized by extreme self-neglect, social withdrawal, lack of shame, apathy, and compulsive hoarding of rubbish. It is found mainly in elderly persons and is associated with progressive dementia.

The syndrome is named after the Greek philosopher Diogenes of Sinope (412 or 404 BCE-323 BCE), who was a Cynic and Minimalist. The philosophy of cynicism is based on the belief that life should be lived virtuously in agreement with nature by rejecting all conventional desire for wealth, power, and fame, and to live simply and free of all possessions. Diogenes took cynicism to its extreme. He is said to have lived in a wine barrel on the streets of Athens, promoting ideas of nihilism and animalism. Famously, when asked by Alexander the Great, the most powerful person of that time, what he wanted most in the world, he replied, "For you to get out of my sunlight!" The syndrome is actually a misnomer because Diogenes was not known to hoard or neglect his own hygiene, and he sought discussions with other people in the agora.

Recent research on Diogenes syndrome has placed a heavy importance on support of social relationships in recovery. It was reported that 94% of adults with Diogenes syndrome had irregular levels of social support.[12]

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