Question

What are culture-bound syndromes? What are some examples of culture-bound syndromes? Are culture-bound syndromes reflective of universal trends? Why or why not?

Answer 1

A culture-bound syndrome is a collection of signs and symptoms that is restricted to a limited number of cultures by reason of certain psychosocial features.Such syndromes are considered as illnesses indigenous to that culture that are not recognized outside that particular culture. Culture-bound syndromes are usually restricted to a specific setting, and they have a special relationship to that setting. Because culture-bound syndromes are classified on the basis of common etiology (e.g., magic, evil spells, angry ancestors), clinical pictures may vary. These syndromes are recurrent geographically specific patterns of aberrant behaviour and troubling experience which may or may not relate to the nosological structure of international psychiatric classificatory systems. In the past it was believed that culture-bound syndromes occurred only in the country or region of origin. However, with significant population movements and the tendency for immigrants to remain within their culture (despite having moved to a new country), culture-bound syndromes have been observed in other parts of the world. DSM describes these as having localised, folk, diagnostic categories that frame coherent meanings for certain repetitive, patterned and troubling sets of experiences and observations.Common features of a culture-bound syndrome include: categorisation as a disease in the culture (i.e. not a voluntary behaviour or false claim); widespread familiarity in the culture; and the condition is usually recognized and treated by the folk medicine of the culture.

Examples of cultural bound syndrome include the following.Genital retraction syndrome is where an individual is overcome with the belief that genitals are retracting into the body, shrinking, or may be imminently removed or disappear. In South-East Asia this is known as Koro. In China, the term used for the condition is shook yangy. Dhat syndrome is found in the Indian subcontinent where males report that they suffer from premature ejaculation or impotence, and believe that they are passing semen in their urine. Neurasthenia is a condition with symptoms of fatigue, anxiety, headache, impotence, neuralgia and depressed mood. In China a similar syndrome is known as shenjing shuairuo. In Japan the condition is known as shinkeisuijaku.Amok is another culture bound syndrome from the Malay/Indonesian/Filipino meaning ‘mad with rage’ The phrase is particularly associated with a specific sociopathic syndrome in Malaysian culture. In a typical case of running amok, a male who has shown no previous inclination to violence will acquire a weapon and, in a sudden frenzy, attempt to kill or seriously injure anyone he encounters. Susto, a ‘fright sickness’, is indigenously attributed to ‘soul loss’ resulting from traumatic experiences. Among Native Indian populations of Latin America, susto may be conceptualised as a case of spirit attacks. Ghost sickness is native to American Indian tribes and believed to be caused by association with the dead or dying and is sometimes associated with witchcraft. It is considered to be a psychotic disorder of Navajo origin. Its symptoms include general weakness, loss of appetite, a feeling of suffocation, recurring nightmares and a pervasive feeling of terror.Wendigo psychosis is a culture-bound disorder which involves a craving for human flesh and the fear that one will turn into a cannibal. This once occurred frequently among Algonquian Indian cultures, though it has come down with urbanization. Latah is a condition of hyper startling found in the Middle East and South-East Asia and is found mainly in adult women. The afflicted have a severe reaction to being surprised in which they lose control of their behaviour, mimic the speech and actions of those around them and sometimes obey any commands given them.Hwabyeong is a Korean term meaning ‘anger illness’ and manifests as a wide range of physical symptoms, in response to emotional disturbance. Seen mostly in menopausal females, sufferers report symptoms such as a heavy feeling in the chest, perceived abdominal mass, sleeplessness, hot flushes, cold flushes and blurred vision. They may also demonstrate symptoms such as anxiety, depression, obsessive–compulsiveness, as well as anorexia, paranoia or fearfulness, absent-mindedness and irritability. 'Brain fag' derives from West Africa and generally manifests as vague somatic symptoms, depression and difficulty concentrating. It has similar symptoms to the Trinidadian illness studiation madness. The features of Ataque de nervios include uncontrollable shouting, attacks of crying, trembling, heat in the chest and head, and verbal and physical aggression. The syndrome is seen in Latin American and Latin Mediterranean groups. Dissociative experiences, seizures and fainting are also seen.A list of 168 so-called culture-bound syndromes was compiled in a glossary by Hughes (1985), while the Diagnostic and Statistical Manual of the American Psychiatric Association, 4th edition, contains a glossary with 25 entries.