This is a culture-specific disorder (see Culture-Bound Syndromes). The term refers to a response to interpersonal problems and disappointment. The symptoms are mutism, anger, withdrawal, and suicide (Paniagua, 2000). Additional symptoms are immobility, depression, psychosis, and psychomotor retardation (Lewis, 1975). Also, it can be translated as pouting (James, 1996). The wacinko syndrome is found in the American Indians (Paniagua, 2000). It is specifically found in the Oglala Sioux, which has a population of 13,000 people. The indigenous practitioners recognize the syndrome as a distinctive disorder. Non-Indian practitioners may not recognize it, however, even though the symptoms are not culture bound. Most cases are diagnosed as reactive depressive illness (Lewis, 1975). In addition, most patients are misdiagnosed with schizophrenia (James, 1996). Wacinko can be depression and ...