Do ‘‘Culture-Bound’’ Syndromes Exist?

Throughout this chapter, we referred to ‘‘culturebound syndromes,’’ or syndromes that are found only in one culture. By definition, culture-bound syndromes are more than variants of ‘‘universal’’ disorders and are determined by the specific beliefs and practices of a particular culture. Originally, ‘‘culture-bound’’ syndromes were limited to syndromes observed in nonWestern cultures, but more recent modifications of the term acknowledge that certain syndromes may occur only in Western cultures. Among these is multiple personality disorder (MPD). Although MPD is extremely rare in the United States, in Japan, it is virtually nonexistent. Takahashi found that among all inpatients in a Japanese hospital from 1983–1988, not one diagnosis of MPD was made, based on DSM-III and DSM-III-R criteria. Takahashi argues that MPD is inconsistent with Japanese cultural norms.

In such a culture where one’s thinking, or identity in the sense of western cultures, is altered to fulfil society’s needs, the need for an individual to develop a psychiatric disorder such as MPD might not be very strong. Heated debate exists regarding whether culturebound syndromes actually exist. The DSM-IV acknowledged the existence of such disorders by including a list of culture-bound syndromes as an appendix. However, recent evidence suggests that many syndromes that were previously considered ‘‘culture-bound’’ are variations of depression and anxiety. Thus, many critics of the DSM-IV argue that the term ‘‘culture-bound syndrome’’ assumes that culture is a secondary process and exists only in extreme forms, when in fact, culture influences all aspects of mental illness. Whether or not one views a specific syndrome as ‘‘culturally bound’’ may depend largely upon what one considers the defining aspect of mental illness. If one focuses only on symptoms, many syndromes that were traditionally considered ‘‘culturally bound’’ could be considered cultural manifestations of depression and anxiety. However, if one focuses on cultural meanings, then to some degree, all syndromes are ‘‘culturally bound.’’