Disorders such as schizophrenia, anxiety disorders, major depression or obsessive-compulsive disorder are widely known by the vast majority of the population.

These are conditions that are consistently present in the vast majority of cultures on the planet, occasionally varying in their manifestations but presenting distinctive majority patterns.

However, not all mental disorders are so common. There are some syndromes and disorders that are considered to occur specifically in certain cultures, linked to their beliefs and lifestyles. One of these cases is known as Amok syndrome, or homicidal insanity .

A rare disorder: exploring Amok Syndrome

Amok syndrome is a very rare disorder whose main characteristic is the appearance of a wild rage that induces the subject to a murderous behavior , provoking the murder or serious injuries with the intention of killing all the people the subject meets.

This outbreak or episode occurs apparently randomly, without any phenomenon causing the attack. Such an episode usually ends with the death of the subject, being produced either by the suicide of the subject or by the fact of being shot in order to stop the attack.

It has also been observed that in many cases individuals with this syndrome present a series of prodromes or symptoms that indicate the possible future presence of the disorder. Specifically , moderate depression, isolation and high levels of fatigue are common .

In cases where the subject who presents Amok’s syndrome survives, the presence of lacunar amnesia (i.e. they do not remember the homicidal episode) and a high level of physical and mental fatigue and exhaustion have been observed.

It is a syndrome traditionally linked to culture, first visualized and described in the Malaysian population. Historically it has also been associated with other cultures, as in the case of the Viking Berserker warriors, who were known to enter a state of rage in battle during which they attacked both enemies and allies with special ferocity and resistance to pain.

Etiology (causes) of Amok

The causes of this disorder are not yet well known, due to its low general prevalence and the fact that a large number of those affected end up dying, either by suicide or by being killed to stop their performance.

However, it is noted that for the Malaysian population this syndrome was considered a response to frustration and humiliation . Likewise, the religious beliefs of this population, which included the ideas of possession by spirits, facilitated the suggestion and presence of this type of actions, as well as a magical interpretation of the phenomenon.

It has also been found that the presence of chronic physical disorders is relatively common in subjects with Amok syndrome, and it is not entirely out of the question that this happens during an episode of substance intoxication. In particular, it has been observed that in the Indonesian regions where this disorder was detected, consumption by both adults and infants of Brugmansia suaveolens or floripon is common, which is used as a painkiller as well as to prepare hallucinogenic drinks.

A disorder not as culture-specific as thought

Although considered a culture-related disorder, Amok syndrome has recently been expanded and exported to a more global level , being associated by some experts with multiple recent mass murders. However, it is not clear to what extent this is due to cultural exchange, as the increasing scope of globalization cannot be separated from other factors that could also explain this phenomenon.

Typical profile of the affected person

It has been mentioned before that Amok syndrome is a very rare and difficult disorder to see in the population. However, the serious implications and consequences of this syndrome have led to the study of both this disorder and the characteristics of those who suffer from it, with which common patterns have been visualised in the subjects who have suffered from it .

Generally, the subjects in whom this syndrome arises are usually young males, who present a shy, introverted and not very expressive personality . They tend to be subjects who present a high level of vital inhibition and sometimes feelings of dissatisfaction and frustration. It is common that throughout their lives they have lived some type of traumatic experience that is unbearable for them.

The presence of a history of very prolonged harassment, as in the case of bullying, or of violence within the family is a frequent element found in subjects who have suffered from this disorder, suggesting that the suffering of the outbreak may be due to sequelae of these phenomena that arise causing a homicidal rage.

Increased prevalence

Recently an increase in the prevalence of Amok syndrome has been detected . This is due to the well-known so-called effect, through which the observation of certain cases and their consequences may cause other people to imitate the actions of these subjects.

Thus, there is a learning of a form of behavior that it is possible that the subjects did not have previously, being able these to value and desire the level of social attention that they observe for themselves. The same phenomenon has been observed in cases of gender violence, suicide, vandalism and even homicides or terrorism.

Crimes apparently associated with Amok syndrome

Amok syndrome is an extremely rare and uncommon disorder, but the fact that it can lead to the commission of mass murders has prompted many known massacres to be linked to this syndrome .

Some known cases that have been associated with this disorder are as follows:

1. Columbine Massacre

On April 20, 1999, this notorious massacre took place. In it, two students assaulted the Columbine High Scool facility, killing 15 people and injuring 24 others before both perpetrators committed suicide.

2. Virginia Tech Massacre

Another mass killing or mass murder that’s been linked to Amok syndrome. In this case in 2007 the subject involved killed thirty-two people before committing suicide.

3. Massacre at Sandy Hook Elementary School

In this well-known case, in 2012, a teenager took the lives of a total of twenty children and seven adults, shortly before committing suicide.

4. Munich shooting

In July of this year 2016, a young man with no apparent ties to terrorist organizations carried out a massacre in which nine people lost their lives and twenty-seven were injured. The perpetrator of the act would end his life soon after.

Caution in linking blood crimes to this syndrome

It must be taken into account that in many of the cases cited the person had a previous intention and planning before carrying out their attack. The definition of the disorder does not indicate that it is a premeditated act, so it is debatable whether these massacres are due to the presence of an Amok syndrome. Nevertheless, in the opinion of many professionals, the characteristics of these homicidal behaviours can be linked to this disorder.

The association of this disorder with violent crime has meant that some killings and murders committed without apparent motives have been considered to be due to Amok syndrome, as seen above. However it must be taken into account that most of the crimes are committed by people without any mental pathology , whether or not their actions have a clear objective for the others, so the issue must be treated with caution and not be reductionist considering that any apparently unjustified blood crime is due to Amok or other syndromes or mental diseases.

The murders, many in most cases, are explained not by situations linked to mental disorders, delusions and hallucinations, but by contexts in which a conflict has gradually escalated , situations in which there is organised crime, or by some kind of ideological and discriminatory indoctrination.

Treatment

Because this is an extremely rare phenomenon and is characterized by sudden and unexpected occurrences, the only immediate treatments are based on the physical containment of the patient for the duration of the episode. It is important to do so bearing in mind that the only objective is that no one is harmed, so punishment or any act of revenge, of course, is out of the question.

However, it is in the preventive work where one could find a greater effectiveness and be able to avoid massacres . The treatment of possible psychological and social conditions that may lead to outbreaks of this type may be essential. Thus, loyalty to the follow-up of psychological and pharmacological treatments is important.

Bibliographic references:

  • World Health Organization. (1992). International Classification of Diseases – Tenth Revision. Madrid: WHO.
  • Sofsky, W. (2004). Times of horror. Amok, violence, war. Madrid: Editorial Siglo XXI.
  • Westermeyer, J. (1972). A comparison of Amok and other homicide in Laos. American Journal of Psychiatry, 129: 703-709.