[Culture-bound syndromes: pertinence as a diagnostic category]

Abstract

Culture-bound syndromes (CBS) are supposedly confined to one specific cultural areas. These syndromes were first studied by western anthropologists and psychiatrists working overseas, and later by practitioners treating patients from societies with traditional customs and values. The latest edition of the American Psychiatry Association classification (DSM IV) includes an annex on CBS. This report gives a concise background of the process that led to the inclusion of this annex. Then using Koro (a sudden and intense fear that the genitals organs will recede into the body) as an example, a number psychopathological parallels are drawn between CBS and classic manifestations of individual and mass hysteria. The pertinence of individualizing the CBS in the psychiatric nosography including the epistemologic implications is analyzed with reference to the concepts of the French and American Schools of Anthropology. Since attitudes toward mental illness are culturally determined and subject to variation in time and space, we feel that this debate should be placed within the context of a general dialectic between etic (universality) and emic (cultural specificity) rather than a controversy on the need for an annex on CBS in the DSM IV.