, abbreviated SMS, is a psychological disorder proposed by professor Makoto Natsume of Osaka Shoin Women's University, in which subjects develop depression and physical illness as a result of prolonged, unnatural smiling. Natsume proposed the disorder after counselling students from the university in his practice and noticing that a number of students had spent so much time faking their smiles that they were unaware that they were smiling even while relating stressful or upsetting experiences to him. Natsume attributes this to the great importance placed on smiling in the Japanese service industry, particularly for young women.

Smiling is an important skill for Japanese women working in the service industry. Almost all service industry companies in Japan require their female staff to smile for long periods of time. Natsume says that his female patients often talk about the importance of smiling when the topic of the conversation is on their workplace. He relates examples of patients saying that they felt their smile had a large effect on whether they were hired or not, and that their superiors had stressed the effect that good smiles had on customers. According to Natsume, this atmosphere sometimes causes women to smile unnaturally for so long that they start to suppress their real emotions and become depressed.

Japanese author Tomomi Fujiwara notes that the demand for a common smile in the workplace emerged in Japan around the 1980s, and blames the cultural changes wrought by the Tokyo Disneyland, opened in 1983, for popularizing the demand for an obligatory smile in the workplace.

The smile mask syndrome has also been identified in Korea. Korean writer Bae Woo-ri noted that smiling gives one a competitive advantage over the others, and has become a necessary attribute of many employees, just like a "neat uniform". Yoon-Do-rahm, a psychology counselor, compared the current society, which is full of smile-masks, to a clown show; both are characterized by plentiful, yet empty and fake, smiles.

Smile mask syndrome can cause physical problems as well as mental ones. Natsume relates that many of his patients developed muscle aches and headaches as a result of prolonged smiling, and says that these are similar to the symptoms of repetitive strain injury.

The causes of PTSD are: Natural or human disasters, war, serious accident, witness of violent death of others, violent attack, being the victim of sexual abuse, rape, torture, terrorism or hostage taking.

Predisposing factors

The predisposing factors are: Personality traits and Previous history of Psychiatric illness.

Psychiatric consultation: Exploration of memories of the traumatic event, relief of associated symptoms and counseling.

Promoters of this suicide method recommend it to terminally ill patients. However, across the world, most people who use suicide bags are physically healthy. Instead of having incurable cancer or other life-threatening physical diseases, most of the users have psychiatric disorders or substance abuse problems that might possibly be addressed through medical and psychological treatment. The demographics of its users varies; in one survey, the method had been used mostly by middle-aged adults in failing health, who were attracted to the relative nonviolence of the method.

This suicide method is also typically used by younger or middle-aged adults, rather than by older adults. In the US, it is more commonly chosen by non-Hispanic white males than by women or people of other races.

The causes of ORS are unknown. It is thought that significant negative experiences may trigger the development of ORS. These have been considered as two types: key traumatic experiences related to smell, and life stressors present when the condition developed but which were unrelated to smell. In one review, 85% of reported cases had traumatic, smell-related experiences, and 17% of cases had stress factors unrelated to smell. Reported smell-related experiences usually revolve around family members, friends, co-workers, peers or other people making comments about an odor from the person, which causes embarrassment and shame. Examples include accusation of flatulence during a religious ceremony, or being bullied for flatulence such at school, accidental urination in class, announcements about a passenger needing to use deodorant over speaker by a driver on public transport, sinusitis which caused a bad taste in the mouth, mockery about a fish odor from a finger which had been inserted into the person's vagina in the context of a sexual assault, and revulsion about menarche and brother's sexual intimacy. It has been suggested that a proportion of such reported experiences may not have been real, but rather early symptom of ORS (i.e. referential thoughts). Examples of non smell-related stressful periods include guilt due to a romantic affair, being left by a partner, violence in school, family illness when growing up (e.g. cancer), and bullying.

The importance of a family history of mental illness or other conditions in ORS is unclear, because most reported cases have lacked this information. In some cases, there has been reported psychiatric and medical conditions in first degree relatives such as schizophrenia, psychosis, alcoholism, suicide, affective disorders, obsessive compulsive disorder, anxiety, paranoia, neurosis, sociopathy, and epilepsy. Sometimes more than one family member had a noteworthy condition.

Neuroimaging has been used to investigate ORS. Hexamethylpropyleneamine oxime single-photon emission computed tomography (HMPAO SPECT) demonstrated hypoperfusion of the frontotemporal lobe in one case. That is to say, part of the brain was receiving insufficient blood flow. In another, functional magnetic resonance imaging was carried out while the person with ORS listened to both neutral words and emotive words. Compared to an age and sex matched healthy control subject under the same conditions, the individual with ORS showed more activation areas in the brain when listening to emotionally loaded words. This difference was described as abnormal, but less pronounced as would be observed in the brain of a person with a psychotic disorder.

When untreated, the prognosis for ORS is generally poor. It is chronic, lasting many years or even decades with worsening of symptoms rather than spontaneous remission. Transformation to another psychiatric condition is unlikely, although very rarely what appears to be ORS may later manifest into schizophrenia, psychosis, mania, or major depressive disorder. The most significant risk is suicide.

When treated, the prognosis is better. In one review, the proportion of treated ORS cases which reported various outcomes were assessed. On average, the patients were followed for 21 months (range: 2 weeks to 10 years). With treatment, 30% recovered (i.e. no longer experienced ORS odor beliefs and thoughts of reference), 37% improved and in 33% there was a deterioration in the condition (including suicide) or no change from the pre-treatment status.

Hedonophobia is an excessive fear or aversion to obtaining pleasure. The purported background of some such associated feelings may be due to an egalitarian-related sentiment, whereby one feels a sense of solidarity with individuals in the lowest Human Development Index countries. For others, a recurring thought that some things are too good to be true has resulted in an ingrainedness that they are not entitled to feel too good. The condition is relatively rare. Sometimes, it can be triggered by a religious upbringing wherein asceticism is propounded.

Hedonophobia is formally defined as the fear of experiencing pleasure. 'Hedon' or 'hedone' comes from ancient Greek, meaning 'pleasure' + fear: 'phobia'. Hedonophobia is the inability to enjoy pleasurable experiences, and is often a persistent malady. Diagnosis of the condition is usually related to the age of 'maturity' in each country where the syndrome exists. For instance, in the US a person must be 18 years old to be considered an adult, whereas in Canada he or she must be 18 or 19 years old, depending on the province of residence. Globally, the ages range from (+/-) 12 to 24 years and are mainly determined by traditional ethical practices from previous societies. High anxiety, panic attacks, and extreme fear are symptoms that can result from anticipating pleasure of any kind. Expecting or anticipating pleasure at some point in the future can also trigger an attack.

Hedonophobics have a type of guilt about feeling pleasure or experiencing pleasurable sensations, due to a cultural background or training (either religious or cultural) that eschews pleasurable pursuits as frivolous or inappropriate. Oftentimes, social guilt is connected to having fun while others are suffering, and is common for those who feel undeserving or have self-worth issues to work through. Also, there is a sense that they shouldn't be given pleasures due to their lack of performance in life, and because they have done things that are deemed "wrong" or "undeserving."

To determine the depth of the diagnosis for those who suffer from hedonophobia, background is crucial. For example, when a child is taught that a strong work ethic is all that makes them worthy of the good things in life, guilt becomes a motivator to move away from pleasure when they begin to experience it. The individual learns that pleasures are bad, and feeling good is not as sanctified as being empathetic towards those who suffer.

C.B.T. (Cognitive Behavioral Therapy) is an effective approach to the resolution of past beliefs that infiltrate and affect the sufferer's current responses to various situations. Medication is only necessary when there is an interference in the person's normal daily functioning. Various techniques are used by those afflicted with the condition to hide, camouflage or mask their aversion to pleasure.

Any relationship that includes things that are pleasurable is re-established when the sufferer learns that he is not worthy of anything pleasurable, or that he only deserves the opposite of those things which are pleasurable. A disconnect is necessary to determine the sufferer's lack of ability to intervene in the overall process.

A suicide bag, also known as an exit bag or hood, is a euthanasia device consisting of a large plastic bag with a drawcord used to commit suicide through inert gas asphyxiation. It is usually used in conjunction with an inert gas like helium or nitrogen, which prevents the panic, sense of suffocation and struggling during unconsciousness (the hypercapnic alarm response) usually caused by the deprivation of oxygen in the presence of carbon dioxide. This method also makes the direct cause of death difficult to trace if the bag and gas canister are removed before the death is reported.

Suicide bags were first used during the 1990s. The method was mainly developed in North America.

Sigmund Freud has footnoted the possibility that this fear may be derived from a lack of ingenuity allowing one to ornamentally distance the copulatory organs from the excretory organs. Such a condition can affect both men and women. For others, symptoms include what characterizes a panic attack. It does not necessarily have to be induced by an uncovered penis, but may also result from seeing the manbulging outline or curvature of the penis, perhaps through clothes consisting of thin fabric. In more extreme cases it has been likened to the fight or flight response ingrained within the human body wherein an individual ceases to be intimate with their male partner and is unable to visit mixed gender establishments where people are likely to wear more revealing clothing, such as a gym, beach, cinema or livingrooms with a switched on monitor. The fear can recur through any of the senses including accidental touch, sight, hearing the word penis or thinking about an erection. The phobia may have developed from a condition such as dyspareunia, a trauma (usually sexual) that occurred during childhood, but can also have a fortuitous origin. In literature covering human sexuality, it is used as an adjective only to negatively allude to penetrative sex acts. Men who have the phobia may try to avoid wearing jeans and other light fabrics, especially in public. Some analysts have purported that the condition may be inherited or may be a combination of genetic inheritance and life experiences. For men with the condition, one of the byproducts is difficulty consummating with a partner due to a sense of vulnerability. This vulnerability may have developed during childhood because they grew up being told by their parents that sex and its physiological functions were evil, sinful and dirty, but were subsequently unable to detach such shameful feelings nor reverse it upon reaching adulthood, even when romantic initiatives were subsequently approved of or encouraged by their parents.

Sometimes the word is used in a sense wherein it is metaphorical and unrelated to its etymological origins, as in for instance when a man sees another man as a rival and a potential source of infidelity for his spouse. Other reviews have applied the term as a euphemism or allegory to indicate that society is in contemporary times less willing to be objective and straighforward in discussions of the physiological aspects of the young male body in general due to prudery, or a celibacist and puritan standpoint that in particular targets men and boys. For instance, Ken Corbett has theorized the fact of widespread absence of the penis as an object of discussion in children's books and parenting books as evidencing that ""a kind of phallophobia has crept into our cultural theorizing"". In other writings it has been used as an epithet to describe the lesbian or female asexual aversion to male sexuality. Author Fawzi Boubia defines phallophobia as a hostility towards the stronger male gender. The term has also been used as a substitute to indirectly express an aversion to procreation. Phallophobia has also been used as an algorithm in studies of heuristics in robotic decision making in themes related to sexual temperance. In criticisms of anti-male sexism, phallophobia is used as an epithet to deride double standards and hypocrisy in the legal system, all down to the set of genitalia one possesses. One of the byproducts of this phobia among women is that it may result in them faking an orgasm to mask their feeling of revulsion around their male spouse. Forms of treatment may include intensive counselling and therapy sessions.

Möbius syndrome results from the underdevelopment of the VI and VII cranial nerves. The VI cranial nerve controls lateral eye movement, and the VII cranial nerve controls facial expression.

The causes of Möbius syndrome are poorly understood. Möbius syndrome is thought to result from a vascular disruption (temporary loss of bloodflow) in the brain during prenatal development. There could be many reasons that a vascular disruption leading to Möbius syndrome might occur. Most cases do not appear to be genetic. However, genetic links have been found in a few families. Some maternal trauma may result in impaired or interrupted blood flow (ischemia) or lack of oxygen (hypoxia) to a developing fetus. Some cases are associated with reciprocal translocation between chromosomes or maternal illness. In the majority of cases of Möbius syndrome in which autosomal dominant inheritance is suspected, sixth and seventh cranial nerve paralysis (palsy) occurs without associated limb abnormalities.

The use of drugs and a traumatic pregnancy may also be linked to the development of Möbius syndrome. The use of the drugs misoprostol or thalidomide by women during pregnancy has been linked to the development of Möbius syndrome in some cases. Misoprostol is used to induce abortions in Brazil and Argentina as well as in the United States. Misoprostol abortions are successful 90% of the time, meaning that 10% of the time the pregnancy continues. Studies show that the use of misoprostal during pregnancy increases the risk of developing Möbius syndrome by a factor of 30. While this is a dramatic increase in risk, the incidence of Möbius syndrome without misoprostal use is estimated at one in 50000 to 100000 births (making the incidence of Möbius syndrome with misoprostol use, less than one in 1000 births). The use of cocaine (which also has vascular effects) has been implicated in Möbius syndrome.

Some researchers have suggested that the underlying problem of this disorder could be congenital hypoplasia or agenesis of the cranial nerve nuclei. Certain symptoms associated with Möbius syndrome may be caused by incomplete development of facial nerves, other cranial nerves, and other parts of the central nervous system.

Williams syndrome is a microdeletion syndrome caused by the spontaneous deletion of genetic material from the region q11.23 of one member of the pair of chromosome 7, so that the person is hemizygous for those genes. The deleted region includes more than 25 genes, and researchers believe that being hemizygous for these genes probably contributes to the characteristic features of this syndrome. "CLIP2", "ELN", "GTF2I", "GTF2IRD1", and "LIMK1" are among the genes that are typically deleted from one chromosome in people with Williams syndrome. Researchers have found this hemizygosity for the "ELN" gene, which codes for the protein elastin, is associated with the connective-tissue abnormalities and cardiovascular disease (specifically supravalvular aortic stenosis and supravalvular pulmonary stenosis) found in many people with this syndrome. The insufficient supply of elastin may also be the cause of full cheeks, harsh or hoarse voice, hernias and bladder diverticula often found in those with Williams syndrome. Studies suggest that hemizygosity in "LIMK1", "GTF2I", "GTF2IRD1", and perhaps other genes may help explain the characteristic difficulties with visual–spatial tasks. Additionally, there is evidence that the hemizygosity in several of these genes, including "CLIP2", may contribute to the unique behavioral characteristics, learning disabilities, and other cognitive difficulties seen in Williams syndrome.

Otofacial syndrome is an extraordinarily rare congenital deformity in which a person is born without a mandible, and, subsequently, a chin.

In nearly all cases, the child does not survive because it is unable to breathe and eat properly. Even with reconstructive surgery, the tongue is extremely underdeveloped, making unaided breathing and swallowing impossible.

After the last primary tooth is lost, usually around the age of twelve, final orthodontic treatment can be initiated. A patient that has not been able to close or swallow well probably will have an open bite, deficient lower-jaw growth, a narrow archform with crowded teeth, and upper anterior flaring of teeth. Orthognathic (jaw) surgery may be indicated. This should be completed in most situations before the smile surgery where the gracilis muscle is grafted to the face.

Genetic links to 13q12.2 and 1p22 have been suggested.

Williams syndrome has historically been estimated to occur in roughly 1 in every 20,000 live births. However, more recent epidemiological studies have placed the occurrence rate at closer to 1 in every 7,500 live births, a significantly larger prevalence. As an increasing body of evidence suggests that Williams syndrome is more common than originally noted (approximately 6% of all genetic cases of developmental disability), researchers have begun to theorize past under-diagnosis of the syndrome. One theorized reason for the increase in epidemiological estimates is that there exists a substantial minority of individuals with the genetic markers of Williams syndrome who lack the characteristic facial features or the diminished IQ considered to be diagnostic of the syndrome, who often are not immediately recognized as people with the syndrome.

Nablus mask-like facial syndrome is a microdeletion syndrome triggered by a deletion at chromosome 8 q22.1 that causes a mask-like facial appearance in those affected.

It is characterized by a narrowing of the eyes, tight, glistening facial skin, and a flat, broad nose. Other features of the syndrome include malformed ears, unusual hair patterns on the scalp, bent fingers and toes and joint deformities in the hands and feet, unusual teeth, mild developmental delay, cryptorchidism, and a generally happy disposition. It is a rare genetic disorder by inheritance found in Palestinian people named after Nablus city in the West Bank. It is part of many new genetic disorders of newborns that is increasing exponentially in Arabs in recent years as reported by Centre for Arab Genomic Studies in Dubai.

The first challenge to survival is assisted breathing and tubal feeding. This is a lifelong affair, generally requiring the patient to spend nearly all of the time under direct hospital care.

American surgeons successfully used bone from the hip of an Irish teenager named Alan Doherty to rebuild a jaw and chin. Surgeons began the procedures in June 2007 and completed the final of seven surgeries on 25 August 2008. Doherty is now able to smile, but is still unable to breathe, eat, or speak on his own.

Witzelsucht (from the German "witzeln", meaning to joke or wisecrack, and "sucht", meaning addiction or yearning) is a set of rare neurological symptoms characterized by a tendency to make puns, or tell inappropriate jokes or pointless stories in socially inappropriate situations. A less common symptom is hypersexuality, the tendency to make sexual comments at inappropriate times or situations. Patients do not understand that their behavior is abnormal, therefore are nonresponsive to others' reactions. This disorder is most commonly seen in patients with frontal lobe damage, particularly right frontal lobe tumors or trauma. The disorder remains named in accordance with its reviewed definition by German neurologist Hermann Oppenheim; its first description as the less focused "Moria" ("stupidity"), by German neurologist Moritz Jastrowitz, was in 1888.

Due to similarity of symptoms of the disorder to the mannerisms of Batman's arch-rival Joker, it is sometimes known as 'The Joker Syndrome'

A brainstem stroke syndrome is a condition involving a stroke of the brainstem. Because of their location, they often involve impairment both of the cranial nuclei and of the long tracts.

A person may have vertigo, dizziness and severe imbalance without the hallmark of most strokes – weakness on one side of the body. The symptoms of vertigo, dizziness or imbalance usually occur together; dizziness alone is not a sign of stroke. Brainstem stroke can also cause diplopia, slurred speech and decreased level of consciousness. A more serious outcome is locked-in syndrome.

The scientific study of the causes of developmental disorders involves many different theories. Some of the major differences between these theories involves whether or not environment disrupts normal development, or if abnormalities are pre-determined.

Normal development occurs with a combination of contributions from both the environment and genetics. The theories vary in the part each factor has to play in normal development, thus affecting how the abnormalities are caused.

One theory that supports environmental causes of developmental disorders involves stress in early childhood. Researcher and child psychiatrist Bruce D. Perry, M.D., Ph.D, theorizes that developmental disorders can be caused by early childhood traumatization. In his works he compares developmental disorders in traumatized children to adults with post-traumatic stress disorder, linking extreme environmental stress to the cause of developmental difficulties. Other stress theories suggest that even small stresses can accumulate to result in emotional, behavioral, or social disorders in children.

A 2017 study tested all 20,000 genes in about 4,300 families with children with rare developmental difficulties in the UK and Ireland in order to identify if these difficulties had a genetic cause.They found 14 new developmental disorders caused by spontaneous genetic mutations not found in either parent (such as a fault in the CDK13 gene). They estimated that about one in 300 children are born with spontaneous genetic mutations associated with rare developmental disorders.

Hutchinson's mask is a patient's sensation that the face is covered with a mask or a gauzy network like cobwebs. This medical sign is associated with tabes dorsalis affecting the trigeminal nerve (fifth cranial nerve CN V). It is named in honour of the English physician Sir Jonathan Hutchinson (1828–1913).

Serotonin and norepinephrine reuptake inhibitor, venlafaxine, were given to case study KS four months after initial stroke that started symptoms of witzelsucht. Changes back to his original behavior were noticeable after daily dose of 37.5 mg of venlafaxine for two weeks. In subsequent two months, inappropriate jokes and hypersexual behavior were rarely noticed. Due to the rareness of this disorder, not much research into potential treatments has been conducted.

There have been 30 cases of Marden-Walker Syndrome reported since 1966. The first case of this was in 1966 a female infant was diagnosed with blepharophimosis, joint contractures, arachnodactyly and growth development delay. She ended up passing at 3 months due to pneumonia.

Symptoms of ADHD include inattentiveness, impulsiveness, and hyperactivity. Many of the behaviors that are associated with ADHD include poor control over actions resulting in disruptive behavior and academic problems. Another area that is affected by these disorders is the social arena for the person with the disorder. Many children that have this disorder exhibit poor interpersonal relationships and struggle to fit in socially with their peers.

Among the medical signs are dacryocystitis, seizures, intellectual disability, and paralysis, each of which is a complication resulting from the diminutive foramina. A common sign reported as a result of the disease has been a difference of the size of the eyes.