Dr. Hiroaki Ota, a Japanese psychiatrist working at the Sainte-Anne Hospital Center in France, coined the term in the 1980s and published a book of the same name in 1991. Katada Tamami of Nissei Hospital wrote of a manic-depressive Japanese patient suffering from Paris syndrome in 1998. In 2004, Dr. Ota and coauthors wrote in a French psychiatric journal that France was the only European country to offer specialized care to Japanese citizens in their own language, as an agreement between the Japanese Embassy and Dr. Ota's department in the Sainte-Anne Hospital. In the article, they state that, between 1988 and 2004, only 63 Japanese patients were hospitalized and referred to Dr. Ota. 50% were between 20 and 30 years old. Of the 63 patients, 48 were diagnosed with schizophrenic or other psychotic disorders. Later work by Youcef Mahmoudia, a physician with the hospitalHôtel-Dieu de Paris, indicates that Paris syndrome is "psychopathology related to travel, rather than a syndrome of the traveler." He theorized that the excitement resulting from visiting Paris causes the heart to accelerate, causing giddiness and shortness of breath, which results in hallucinations in the manner similar to the Stendhal syndrome described by Italian psychiatrist Graziella Magherini in her book La sindrome di Stendhal. Although the BBC reported in 2006 that the Japanese embassy in Paris had a "24-hour hotline for those suffering from severe culture shock", the Japanese embassy states no such hotline exists. Also in 2006, Miyupi Kusama, of the Japanese embassy in Paris, told The Guardian "There are around 20 cases a year of the syndrome and it has been happening for several years", and that the embassy had repatriated at least four Japanese citizens that year. However, in 2011, the embassy stated that, despite media reports to the contrary, it did not repatriate Japanese nationals suffering from Paris syndrome.
Susceptibility
Of the estimated 1.1 million annual Japanese tourists in Paris, the number of reported cases is small. A journal also identified two types of the affliction: Those who have previous history of psychiatric problems and those without morbid history who exhibit the delayed-expression type. In an interview with Slate.fr, Dr. Youcef Mahmoudia, a psychiatrist at the Hôtel-Dieu in Paris, stated that of the fifty pathological travelers hospitalized each year, only 3–5% are Japanese. The French newspaper Libération wrote an article on the syndrome in 2004. In the article, Mario Renoux, the president of the Franco-Japanese Medical Association, states that media and touristic advertising are primarily responsible for creating this syndrome. Renoux indicates that while magazines often depict Paris as a place where most people on the street look like models and most women dress in high fashion brands, in reality neither van Gogh nor models are on the street corners of Paris. In this view, the disorder is caused by positive representations of the cityin popular culture, which leads to immense disappointment as the reality of experiencing the city is very different from expectations: tourists are confronted with an overcrowded and littered city and a less than welcoming attitude by French hospitality workers like shopkeepers, restaurant and hotel personnel without considering the higher safety risks to which tourists used to safer cities are suddenly exposed. In 2014, Bloomberg Pursuits reported the syndrome also affected a few of the million annual Chinese tourists in Paris. Jean-Francois Zhou, president of the association of Chinese travel agencies in France, said "Chinese people romanticize France, they know about French literature and French love stories… But some of them end up in tears, swearing they’ll never come back." The article cited a 2012 survey from the Paris Tourism Office, in which safety and cleanliness received low scores, and also noted that the Paris Police Prefecture website was made available in Chinese, in addition to English and French. However, Michel Lejoyeux, head of psychiatry at Bichat–Claude Bernard Hospital in Paris, noted in an interview that "Traveler’s syndrome is an old story", and pointed to Stendhal syndrome.