 Comparing West African genital-shrinking epidemics with koro in Southeast Asia, the latter has symptoms centered on genital retraction (instead of shrinkage) and fear of death (which is absent in African cases).A study analyzing the West African epidemics from 1997 to 2003 concluded that rather than psychopathology, the episodes were product of normal psychological functioning in undisturbed individuals, who were influenced by the local cultural models or social representations.In the late Middle Ages in Europe, it was believed that men could lose their penises through magical attacks by witches.