Cultural Bound Syndromes

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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
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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: Share the way the patient sees the disorder, and offer the folk medicine treatment, 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, 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 the first choice 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 the second choice 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. The third choice is the most difficult and time-consuming to do without leaving the patient disappointed, insulted, or lacking confidence in the
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