Culture-Bound Syndromes

Researchers refer to culture-bound syndromes, also called culture-related psychiatric disorders, by a variety of terms, such as ethnic psychoses, ethnic neurosis, rare, unclassifiable, collective, and exotic syndromes, and atypical culture-bound reactive syndromes. More recently, culture-bound syndromes have been defined as the development of a unique psychopathology or a collection of signs and symptoms that are observed only in a certain cultural environment.

[Page 131]Culture-bound syndromes present a particular challenge to clinicians, particularly in the area of diagnosis. There is a long debate in the literature about the role of biology and culture in the development of culture-bound syndromes, whether such behavior is universal or locally unique, and whether episodes are “normal” culturally based behavior or examples of “authentic” diseases and disorders. Similar questions include whether culture-bound syndromes are stable over time, whether they are truly distinct entities with commonalties across certain cultures, and whether there are common denominators among the syndromes. Other questions concern whether culture-bound syndromes should be viewed as part of all diagnostic categories of psychiatric illness or as static, bound entities.

The last few decades have witnessed an increased interest in culture-bound syndromes. However, their treatment in diagnostic classification systems has gained attention only in the last several years. Despite the history of culture-bound syndromes in the literature, culture-bound syndromes were not included in the psychiatric diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders until the fourth revision in 1994 (DSM-IV). The DSM-IV includes a list of 25 culture-bound syndromes in Appendix I of the text.