Koro syndrome has traditionally been considered a culturally bound syndrome, characterized by the delusional belief that one's genitalia are retracting and the anxiety caused by the perception of imminent death. Although it is widely regarded as an epidemic in South-east Asia, there are some isolated cases in other cultures as well.

We present a Koro case study and a systematic review, focusing on the presentation and its treatment, in order to make visible this syndrome to Western culture and provide the tools to identify it.

To provide an overview of Koro's presentation, phenomenology and treatment. We also want to clarify the nosology classification of this syndrome and its influence in the reported cases.

We begin describing a new case of Koro syndrome: a Spanish male presented an acute psychosis, the patient had an intellectual disability and a family history of mental illness. A systematic review was done based on articles published in Pubmed following the PRISMA guidelines.

From 117 studies, only 29 met the inclusion criteria. Data were analyzed on several epidemiological and clinical characteristics. We found that Koro syndrome is more often presented as a result of intoxication or as a part of a previous known psychotic disorder. Cases involving patients sharing their delusion have been only reported in Asia.

No specific data could be obtained about epidemiology and pathogenesis, as our conclusion about Koro syndrome was based mainly on few case studies. Pharmacotherapy and social support may be effective in ameliorating the symptoms.

The authors have not supplied their declaration of competing interest.