Meet the X-files syndrome : Mass Psychogenic Illness

It's a paranormal appearance’s story which began in Friday, October 24, 1997, in a northern France's high school. On the eve of the All Souls’ Day holidays, The SAMU (Service d'Aide Médicale d'Urgence, i-e "Emergency Medical Assistance Service") is alerting the Departmental Directorate of Health and Social Affairs (named DDASS) for a strange epidemic: 32 students of the same high school had just been transferred to the nearer hospital emergency service.

A strange epidemic

These students had a mysterious illness, leaving doctors baffled: redness and itching, although minor, that could not be explained by a satisfactory reason. Without being able to establish accurate diagnosis, doctors sent back their patients at home, thinking the manifestations observed were benign. The population, however, seemed worried : firefighters had conducted environmental sampling at the high school, the press was interested in the case and DDASS always wondered about the origin of this sudden epidemic ... Poisoning? Infectious agent? The status of students seemed altogether satisfactory, a little rest during the holidays and this facts would be quickly forgotten ...

But Wednesday, November 5, when students went back to school, the epidemic reappears ... The 6, a Parent Committee provides students and parents to court by filing a complaint against X*. The press has long been on the scene looking for any news on this mysterious freak of nature. Saturday 8, the school head, fearing a spread of a pathogen agent by a student, organized a general search in student school bags ... 10 to 20 cases per day eventually force the medical inspector of public health to look closely at this delicate issue. Wednesday, 12 nov., posters were put up, stating that the disease could represent a danger to pregnant women. A true psychosis develops. 14, finally, the rector decided to close high and middle schools in order them to be disinfected.

Who Framed schoolboys?

Speculations rife, with more than one hundred cases listed and many recurrent cases. Allergic phenomenon, environmental poisoning, infectious agent, presence of dangerous chemicals ... Medical services were at least able to rule out food poisoning, cause several students were affected, including some that were not eating at schools. But the Medical Inspector of Public Health (MISP) has also noticed two other fundamental datas: adults do not seem affected by the phenomenon, which occurs at specific times of the week. These informations probably aroused his suspicions...

Initially he suggested that any new cases in the hospital would be led to Hospital for a dermatological examination and a medical evaluation. Both of them were normal, dermatologists were also puzzled and were only able to diagnose that self-induced injuries or dermatitis artifacts, so, whose origin remains a mystery ...

Given the emotional extent of the phenomenon within the population, the MISP also offers expertise in dermatological CHRU (University research hospital center) of Lille, in the dermatology specialized service. Finally, doctors from CHRU solved the mystery, whose origin dates back to October 17, previous month. 107 cases (71 recidivist cases among them) were then informed of the diagnosis. Necessary measures were taken and no new cases appeared. November 14, the epidemic was finally stopped and the school opened its doors a few days later. But what the hell is the trigger event, October 17, that set the medical machine in motion?

Mulder and Scully, infectious agents?

Given the symptoms, the two dermatologists CHRU experts could only confirm the diagnosis of previous physicians. Intentional self-induced or accidental injuries. One of them, however, noticed the similarity of these lesions with those he had seen a few weeks ago on television, in the X-Files series, which, in 1997, aroused enthusiasm in the French population, especially in adolescents... That looked to be part of the trigger event.

One of the first  affected student confessed voluntarily rubbing to get injuries. Then the atmosphere of anxiety contributed to the expansion of the "epidemic". Surprisingly, new cases appeared only during the weekdays, not on Week-ends ... The MISP ends by suggesting a collective phenomenon initiated by a few cases, more or less voluntary.
Beh Report of a case of Mass psychogenic illness:Distribution of epithelial lesions - Image BEH (2002)
Some explanations : Dark cases are unique non recidivist cases. Grey cases are recidivist ones. note that a few or simply no cases are reported on hollidays or saturday/sunday. First and second alert concerned DDASS. Third arrow is when investigation started. Forth is closure of the school. Fifth is when Dermatologic expertise in the CHRU started and diagnosis of X-files syndrome were established - and explained to "sick" peoples. No new cases were then reported...

Several observations support this hypothesis. The first cases described were those of 4 students, older than the others and regarded as leaders, also presenting some kind of psychological and family disorders. In the first 32 cases as well, many students were part of the same friend group. But that alone, does not explain the extent that the phenomenon has taken. Doctors gave it the sweet name of "X-Files syndrom”. Once diagnosis were established, all turned back to normal. But this syndrome is yet indeed, and is named "Mass Psychogenic Illness", formerly known as Mass hysteria. The name of collective hysteria, considered as pejorative, however, is gradually abandoned.

Note that most of affected peoples are adolescents or (surprise?) Medical staff, as evidenced by many observations made in hospitals or clinics(1). The sex ratio is generally oriented toward a predominance of women, which was the case here: 1.8 girls for 1 boy. The disease, atypical, bizarre, erratic and often resistant to diagnosis, occurs more readily during the hours of work than during the holidays or week-end. Trigger factor may be an anxiety event. In the case of the school, the day of onset of symptoms coincided with the distribution of student appreciation report. The atmosphere of collective anxiety is an aggravating factor and even dominant (that’s precisely why it’s called mass phenomenon). Some psychological predispositions (nervousness, depression, psychiatric history) are also individual risk factors.

If the symptoms are becoming better defined, it remains difficult but indispensable to early evoke this diagnosis, in order to avoid the inertia that leads to collective anxiety. When the media get involved, and that medicine fumbles, we’re quick to worry and to encourage the movement, but may it’s just that ... The truth is out there!

(1) - Weekly Epidemiological Bulletin, No. 15-16, April 24, 2007. Psychogenic syndromes: knowledges and case studies. Institut de veille sanitaire
- B. Letourneau, E. Truth, B. Boone, Bleuzé V., Pons E. (2002). X-Files syndrome in a school . BEH, 01 January 2002.
For more information:
- By the same author, Mass psychogenic phenomena On Psychoweb (fr).
- By the same author, Sick building syndrome (fr).

* I don’t know if the term is correct. French “Plainte contre X” means that some peoples ask justice services to open investigation about a fact, without knowing his origin or peoples responsibles for this.
- I will soon make a descriptive article about this Mass psychogenic illness syndrome.