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In medicine and medical anthropology, a culture-specific syndrome or culture-bound syndrome is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture. There are no objective biochemical or structural alterations of body organs or functions, and the disease is not recognized in other cultures. While a substantial portion of mental disorders, in the way they are manifested and experienced, are at least partially conditioned by the culture in which they are found, some disorders are more culture-specific than others.

The concept of culture-bound syndromes is very controversial and many psychologists, medical doctors, and anthropologists reject the concept. The term culture-bound syndrome was included in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) which also includes a list of the most common culture-bound conditions (DSM-IV: Appendix I). American psychiatrist and medical anthropologist Arthur Kleinman has contributed much to the understanding of these syndromes.

The identification of culture-specific syndromes

A culture-specific syndrome is characterized by:
  1. categorization as a disease in the culture (i.e., not a voluntary behaviour or false claim);
  2. widespread familiarity in the culture;
  3. complete lack of familiarity of the condition to people in other cultures;
  4. no objectively demonstrable biochemical or tissue abnormalities (symptoms);
  5. the condition is usually recognized and treated by the folk medicine of the culture.

Some culture-specific syndromes involve somatic symptoms (pain or disturbed function of a body part), while others are purely behavioral. Some culture-bound syndromes appear with similar features in several cultures, but with locally-specific traits, such as penis panics.

A culture-specific syndrome is not the same as a geographically localized disease with specific, identifiable, causal tissue abnormalities, such as kuru or sleeping sickness, or genetic conditions limited to certain populations. It is possible that a condition originally assumed to be a culture-bound behavioral syndrome is found to have a biological cause; from a medical perspective it would then be redefined into another nosological category.

Western medical perspectives

An interesting aspect of culture-specific syndromes is the extent to which they are “real”. Characterizing them as “imaginary” is as inaccurate as characterizing them as “malingering”, but there is no clear way to understand them from a Western scientific perspective. Culture-specific syndromes shed light on how our mind decides that symptoms are connected and how a society defines a known “disease”. The American Psychiatric Association states the following:

The term culture-bound syndrome denotes recurrent, locality-specific patterns of aberrant behavior and troubling experience that may or may not be linked to a particular DSM-IV diagnostic category. Many of these patterns are indigenously considered to be “illnesses,” or at least afflictions, and most have local names. Althought presentations conforming to the major DSM-IV categories can be found throughout the world, the particular symptoms, course, and social response are very often influenced by local cultural factors. In contrast, culture-bound syndromes are generally limited to specific societies or culture areas and are localized, folk, diagnostic [comma sic] categories that frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observations.

Medical care of the condition is challenging and illustrates a truly fundamental but rarely discussed aspect of the physician-patient relationship: the need to negotiate a diagnosis that fits the way of looking at the body and its diseases of both parties. The physician may do any of the following:
  1. Share the way the patient sees the disorder, and offer the folk medicine treatment
  2. Recognize it as a culture-bound syndrome, but pretend to share the patient’s perspectives and offer the folk medicine treatment or a new improvised treatment
  3. Recognize it as a culture-bound syndrome but try to educate the patient into seeing the condition as the physician sees it

The problem with choice 1 is that physicians who pride themselves on their knowledge of disease like to think they know the difference between culture-specific disorders and “organic” diseases. While choice 2 may be the quickest and most comfortable choice, the physician must deliberately deceive the patient. Currently in Western culture this is considered one of the most unethical things a physician can do, whereas in other times and cultures deception with benevolent intent has been an accepted tool of treatment. Choice 3 is the most difficult and time-consuming to do without leaving the patient disappointed, insulted, or lacking confidence in the physician, and may leave both physician and patient haunted by doubts (“Maybe the condition is real.” or “Maybe this doctor doesn’t know what s/he is talking about.”).

The term culture-bound syndrome has, in many ways, been a controversial topic since it has reflected the different opinions of anthropologists and psychiatrists. Anthropologists have a tendency to emphasize the relativistic and culture-specific dimensions of the syndromes, while physicians tend to emphasize the universal and neuropsychological dimensions (Prince, 2000; Jilek, 2001). Guarnaccia & Rogler (1999) have argued in favor of investigating culture-bound syndromes on their own terms, and believe that the syndromes have enough cultural integrity to be treated as independent objects of research.

Selected list of syndromes


  1. Prince, Raymond H. (2000) In Review. Transcultural Psychiatry: Personal Experiences and Canadian Perspectives. Canadian Journal of Psychiatry, 45: 431–437
  2. Jilek W.G (2001) Psychiatric Disorders: Culture-specific. International Encyclopedia of the Social and Behavioral Sciences. Elsevier Science Ltd.
  3. Guarnaccia, Peter J. & Rogler, Lloyd H. (1999) Research on Culture-Bound Syndromes: New Directions. American Journal of Psychiatry 156:1322–1327, September
  4. Skelly, M. "Fibromyalgia Treatment using cognitive-behavioural principles. A practical approach for therapists." In: Cognitive-behavioural interventions in physiotherapy and occupational therapy By Marie Donaghy, Maggie Nicol, Kate M. Davidson 2008, Elsevier Health Sciences, 2008 ISBN 0750688009 QUOTE, "Fibromyalgia syndrome is a heterogenous chronic pain condition.....remains a controversial diagnosis that some regard as primarily a 'culture-bound syndrome' maintained in particular by iatrogenic factors."[1]
  5. Somatic Presentations of Mental Disorders Joel E. Dimsdale, Yu Xin, Arthur Kleinman, Vikram Patel, William E. Narrow, Darrel A. Regier, Paul J. Sirovatka. 2009.[2]
  6. Griffith EE, Gonzalez CA, & Blue HC. (2003). Introduction to Cultural Psychiatry in Textbook of Clinical Psychiatry, Eds Hales, R., & Yudofsky, S. 4th Edition, Vol.2, 1551-1583. American Psychiatric Publishing, Washington DC.
  7. Leon Chaitow, Peter Baldry, Jan Dommerholt, Graeme Chambers. "Fibromyalgia syndrome: a practitioner's guide to treatment" Elsevier Health Sciences, 2003. ISBN 0443072191[3]
  8. AJ Giannini,HR Black. Psychiatric, Psychogenic and Somatopsychic Disorders Handbook, New Hyde Park, NY,Medical Examination Publishing,1978, pp.235-236. ISBN 0-87488-590-5
  9. AJ Giannini, HR Black. Psychiatric, Psychogenic, and Somatopsychic Disorders Handbook. New Hyde Park, NY, Medical Examination Publishing,1978, pg.265. ISBN 0-87488-590-5
  10. AJ Giannini, HR Black. Psychiatric, Psychogenic and Somatopsychic Disorders Handbook. New Hyde Park,NY, Medical Examination Publishing,1978, pp. 168-169. ISBN 0-87488-590-5
  11. AJ Giannini, HR Black. Psychiatric, Psychogenic and Somatopsychic Disorders Handbook. New Hyde Park, NY, Medical Examination Publishing, 1978, pg. 167. ISBN 0-87488-590-5
  12. Ranjith G, Mohan R. "Dhat syndrome as a functional somatic syndrome: Developing a sociosomatic model" Psychiatry: Interpersonal and Biological Processes 2006.[4]

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