zār spirit possession in iran and african countries: group distress, culture-bound syndrome or cultural concept of distress?

zār is the term used to describe a form of spirit possession common in northern african, eastern african, and some middle-eastern societies. although these regions share some cultural similarities arising from their history of slavery, in these places, zār varies in prevalence, clinical characteristics, and social context. based on a selective review of the literature, this paper looks at the place of zār spirit possession in both dsm-iv and dsm-v; it also examines how zār is manifested in iran and in african countries including sudan, ethiopia, and egypt; and it aims to provide practical information to mental health clinicians so that they can better understand how this cultural concept is practiced by iranians and middle eastern and african immigrants living near the persian gulf coast.