Epidemic psychological disturbance in a Malawian secondary school: a case study in social change

We describe a case of Epidemic Psychological Disturbance (EPD) involving 110 pupils at a Catholic Girls Secondary School in Malawi. The EPD 'syndrome' included 'outward' behaviours (screaming, continuous laughing, crying loudly, falling down and rolling, violently threatening classmates, speaking gibberish) and 'inward' behaviours (refusing to eat, withdrawal, hallucinating, hypersensitivity to noise, and headache at the base of the skull). These problems disappeared when most of the affected pupils were sent home. We consider a number of possible causes for this case of EPD, including physical, psychological, traditional, institutional, and political factors. It is suggested that the present case of EPD can be interpreted as reflecting a defence and protest against certain aspects of the rapid social and political changes which Malawi has witnessed over the past few years