Culture Specific Syndrome

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ultural Bound Syndromes

Culture-bound syndrome

The term culture-bound syndrome was included in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000) which also includes a list of the most common culture-bound conditions (DSM-IV: Appendix I). Included in DSM-IV-TR (4th.ed) the term cultural-bound syndrome denotes recurrent, locality-specific patterns of abnormal behavior and troubling experience that may or may not be linked to a particular DSM-IV-TR diagnostic category. Many of these patterns are naturally considered to be illnesses, or at least afflictions, and most have local names. Although presentations conforming to the major DSM-IV-TR categories can be found throughout the world, the particular symptoms, course, and social response are very often influenced by local cultural factors. In contrast, cultural-bound syndromes are generally limited to specific societies or culture areas and are localized, folk, diagnostic categories that frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observations.

In medicine, 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 identification of culture-specific syndromes:

A culture-specific syndrome is characterized by: categorization as a disease in the culture (i.e., not a voluntary behavior or false claim); widespread familiarity in the culture; complete lack of familiarity of the condition to people in other cultures; no objectively demonstrable biochemical or tissue abnormalities (symptoms); 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”. 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...
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