[Montreal syndrome: Conophobia]

The objective of this perspective article is to explore the creation of a new syndrome specific to the Canadian city of Montreal: Conophobia. In a more academic way, the aim is to think about the process which leads to the creation of a new clinical entity and to question how the name of a disease is chosen. In the literature, it is illustrated by syndromes with a name of a city: Stockholm syndrome, Stendhal syndrome, Pisa syndrome, Havana syndrome, Paris syndrome, Lima syndrome or Copenhagen syndrome. Conophobia is a neologism reflecting a potential syndrome linked to the growing observation of an original suffering invading the metropolis of Quebec: anxiety in relation to a clearly identified object that we calls the Cone. New traffic cones have in fact appeared on the streets, by the thousands dotted throughout the neighborhoods, to mark the start of work on public roads. In the context of this invasion, the first observable behavioral anomalies appeared in the population, signs of suffering, and feelings of helplessness among citizens. Media coverage appeared. Almost 30% of orange cones in a given area remained on the streets for no apparent reason, causing unnecessary obstruction and aesthetic nuisance. We were able to observe some vignettes of this phenomenon which cannot be called a clinical vignette at this stage but which in many respects shares links with phobias. Videos that went viral on the networks even showed individuals in several places enraged by the road works, getting out of their cars, grabbing orange cones and throwing them onto the ground next to the street. To our knowledge, there have yet been no hospitalizations or visits to the emergency unit specifically due to a cone. This new semiology or phenomenology can lead the clinician to be attentive to a possible shift in behavior from normal to pathological. The cursor which demarcates this border needs to be studied. The so-called Montreal syndrome allows us to think about the link between mental health and the identity of a city. This relation needs to be improved. Aid and therapies for individuals already suffering from this insidious syndrome could call for individual interventions by health professionals or more community-based prevention interventions. The creation of such a syndrome is part of a biopsychosocial approach which is familiar to the scientific activity of the University Institute of Mental Health of Montreal (IUSMM).