Everything about Culture-bound Syndrome totally explained
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 isn't recognized in other cultures. While a substantial portion of mental disorders, in the way they're manifested and experienced, are at least partially conditioned by the culture in which they're found, some disorders are more culture-specific than others. The concept of culture-bond syndromes is very controversial and many psychologists, medical doctors, and anthroplogists 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:
- categorization as a disease in the culture (for example, not a voluntary behaviour 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 isn't 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're "real". Characterizing them as "imaginary" is as inaccurate as characterizing them as "
malingering", but there's 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 that: "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. Although 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 categories that frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observations" (American Psychiatric Association, 1994:844).
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
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 choice 1 is that a physician who prides himself on his knowledge of disease likes to think he knows 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 she/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 emphazise the relativistic and culture-specific dimensions of the syndromes, while physicians tend to emphazise 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
General
Western societies
Latin American cultures:
Southeast Asia
East Asia
South Asia
Polynesia
United States (exclusively)
Africa
Selected list of somatoform disorders
Jerusalem syndrome
Medical student syndrome
Somatization disorder
Stendhal syndromeFurther Information
Get more info on 'Culture-bound Syndrome'.
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