Culture-Specific Diagnoses and Their Relationship to Mood Disorders

This chapter examines the relationship between culture-specific diagnoses and mood disorders. How researchers and clinicians refer to cultural syndromes related to mood disorders is a contentious issue. We open our chapter with a brief discussion of the history and controversies (as the quote from Hughes [1985] that opens this chapter indicates) surrounding these labels. We then discuss the relationship between a well-documented range of cultural categories of distress and mood disorders. A key point that we want to make early and often is that there is no one-to-one relationship between these cultural categories and psychiatric disorders as codified in either the American (DSM-IV [American Psychiatric Association, 1994]) or international (ICD-10 [World Health Organization, 1992]) diagnostic systems. The relationship between cultural categories and psychiatric diagnoses needs much more careful investigation. We offer a program of such research based on our previous work (Guarnaccia & Rogler, 1999). Another key issue is that only a few of the many cultural forms of expressing distress have received sustained research attention integrating cultural and psychiatric research methods. We focus our review on those syndromes, particularly ataques de nervios, neurasthenia, and susto, which have received the most intensive research and have been shown to be associated in some ways with depression and anxiety. We end the chapter with some suggestions for responding to culture-specific diagnoses in clinical settings and for the incorporation of these syndromes into future versions of the diagnostic manuals. 1 ____ 0 ____ 1 ____ 34023_u03_UNCORR_PRF.3d_32_07-05-07