Today's psychiatric disorders dance to a different beat


Justin Thomas
  • English
  • Arabic

Between the 13th and 16th century a mysterious "mental illness" swept across most of Northern Europe. Those afflicted didn't hear voices or see frightening visions, this was a radical departure from the classical presentation of insanity. This was a totally new form of mania; a severe and enduring disorder rather curiously characterised by an overwhelming urge to dance.

And dance the afflicted did. Some unfortunate souls literally danced themselves to death, reportedly expiring from exhaustion or cardio vascular complications.

Perhaps an even more bizarre attribute of this medieval psychopathology is that it appeared to be socially contagious.

Reports from the German city of Strasbourg in 1581 describe how an initially solitary victim to the disorder, Frau Troffea, in less than a month, was gradually joined by a further 400 men, women and children all similarly afflicted. These outbreaks of dancing mania have never been conclusively explained.

Unfortunately, this lack of a definitive explanation is also applicable to the majority of contemporary psychiatric disorders too. Most of today's complaints are equally debilitating, and those experiencing such conditions want answers. However, the truth is, we really don't have definitive answers. There are, of course, competing theories - as there were for dancing mania - but after more than a century of research, we appear no closer to conclusive answers.

Many of our current ideas about the causes of psychological disorder involve theories concerning chemical imbalances in the brain. Such ideas may ultimately prove fruitful, however they are not radically new. Similar chemical theories were offered as explanations of the medieval dancing mania too. One form of the dancing mania, known as Tarantism, commonly reported in southern Italy, was attributed to a toxic spider bite, in other words, it was viewed as having a direct chemical basis.

This idea was tested at the time by one particularly daring doctor who allowed himself to be bitten by the offending spider. The doctor didn't develop Tarantism (dance mania) nor did he dance the Tarantella (the name given to the dance of those afflicted by Tarantism). But perhaps this idea of an arachnid etiology is the origin of the phrase jitterbug - an energetic North America dance style, emerging in the early part of the 20th century?

Another popular theory for certain contemporary psychiatric disorders is that they are, to some extent, socially transmitted. Eating disorders have often been described as being profoundly influenced, if not caused by, social forces. Similar to the medieval dancing mania, it is not uncommon for eating disorders to appear like a contagious outbreak, with a spate of cases all appearing almost overnight in the same high school.

A colleague of mine described how she undertook an awareness day in a remote high school in a small US town. Before the preventive awareness raising visit, the school had never had a reported case of eating disorders. A few months after the preventive event, the school nurse reported an outbreak of five or six cases. Did the awareness raising event increase the likelihood of students reporting such problems, or did it actually teach a new set of behaviours with which to express distress? Again, nothing really new here, such ideas were advanced to explain the dancing mania.

Another similarity with contemporary psychiatric discourse is the idea that the dancing mania provided a socially acceptable cover for engaging in behaviour otherwise considered immoral or indecent. In a medieval Christian society, public dancing, which might also involve de-robing and suggestive movements, would at the very least raise a moral eyebrow or two. For some commentators, the dancing mania was just an excuse for some people to indulge in reprehensible behaviours.

The dancing mania vanished by the middle of the 17th century, or so I thought. A little while back I came home to find two of my young daughters dancing with manic abandon in front of the TV. I was partially comforted to discover that this was a new Xbox kinect game, "Just Dance".

As society changes, so too do the ways we find to express distress. What will be the psychiatric malaise of our Information Age?

Justin Thomas is an associate professor of psychology at Zayed University in Abu Dhabi

Michael Simkins' London Eye column will appear tomorrow

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Disability on screen

Empire — neuromuscular disease myasthenia gravis; bipolar disorder; post-traumatic stress disorder (PTSD)

Rosewood and Transparent — heart issues

24: Legacy — PTSD;

Superstore and NCIS: New Orleans — wheelchair-bound

Taken and This Is Us — cancer

Trial & Error — cognitive disorder prosopagnosia (facial blindness and dyslexia)

Grey’s Anatomy — prosthetic leg

Scorpion — obsessive compulsive disorder and anxiety

Switched at Birth — deafness

One Mississippi, Wentworth and Transparent — double mastectomy

Dragons — double amputee

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

The biog:

From: Wimbledon, London, UK

Education: Medical doctor

Hobbies: Travelling, meeting new people and cultures 

Favourite animals: All of them 

The specs: 2018 Nissan 370Z Nismo

The specs: 2018 Nissan 370Z Nismo
Price, base / as tested: Dh182,178
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Transmission: Seven-speed automatic
​​​​​​​Fuel consumption, combined: 10.5L / 100km

Sole survivors
  • Cecelia Crocker was on board Northwest Airlines Flight 255 in 1987 when it crashed in Detroit, killing 154 people, including her parents and brother. The plane had hit a light pole on take off
  • George Lamson Jr, from Minnesota, was on a Galaxy Airlines flight that crashed in Reno in 1985, killing 68 people. His entire seat was launched out of the plane
  • Bahia Bakari, then 12, survived when a Yemenia Airways flight crashed near the Comoros in 2009, killing 152. She was found clinging to wreckage after floating in the ocean for 13 hours.
  • Jim Polehinke was the co-pilot and sole survivor of a 2006 Comair flight that crashed in Lexington, Kentucky, killing 49.