Pathological Journeys or Help Seeking Behavior: The Case of Travelers to Geneva, An International City

Several international organizations have their headquarters in Geneva and are thus hypothesized to attract both people seeking help for human right abuses and also pathological travelers. The present study aimed at characterizing pathological travelers, a population seldom studied in psychiatry. Patients referred for pathological journeys to the only psychiatric hospital in Geneva were retrospectively identified on the basis of medical certificates. Their medical records were then analyzed. The study covered a 4-year period. Seventy-six patients were identified. They were in majority male, aged less than 50 and single; 62% came from European countries and 84% had some prior psychiatric history; 58% were diagnosed with a psychotic disorder, mainly schizophrenia, acute transient psychotic disorder and delusional disorder. Sixteen patients (21%) had been attracted to Geneva specifically because of its international organizations, while 60 came for other reasons. Prevalence of persecutory delusions was significantly higher among travelers attracted by the “international Geneva” (88% versus 43%, P<0.005). Pathological journeys represent an identifiable cause of psychiatric hospitalization in Geneva. Prospective studies should be conducted using a more precise and restrictive definition of this entity in order to avoid stigmatization of people crossing borders for other motives.