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Culture Effects and Culture-Bound Syndromes

Culture-Bound Syndromes

Cultural Effects

Pathogenic effect

It means the culture directly causes psychopathology.

Pathoselective effect

Pathoselective effects mean culture causes certain traits, for example, the culturally sanctioned suicide of a wife when a husband dies prematurely.


Culture influences the manifestation, for example, delusional content.


Culture reinforces behavioural reactions.


Cultural beliefs affect the frequency of onset by facilitating risk factors.


Culture affects the treatment, stigma, and outcome of schizophrenia; the prognosis of schizophrenia is better in developing nations than in developed nations.

Specific Syndromes


F68 disorder of personality and behaviour-dissociative not psychotic-starts with a sullen period followed by an outburst of violent and sometimes homicidal behaviour-seen in Malaysia, Laos, Philippians, Papua New Guinea, and Puerto Rico. It occurs in Malays, mostly in males. A withdrawal period is followed by an outburst of homicidal aggression, lasting several hours until overwhelmed or killed. The subject then passes into a deep sleep for several days and will be amnesic about the event.

Ataque de Nervious

F45 somatoform.

an attack of distress wherein sudden shouting, crying, beating oneself, and panic attacks occur with a sense of being out of control. They may have a loss of consciousness or amnesia afterwards. It relates to stress-similar to dissociative trance-Hispanic.


North America-term for a male who has assumed the female gender role.

Bouffée délirante

It occurs in West Africa and Haiti. Sudden outbursts of aggressive behaviour, agitation, confusion, and psychomotor excitement. Clinicians have seen in French-speaking nations where a sudden outburst of agitated and aggressive behaviour and confusion resembles an episode of a brief psychotic disorder (Haiti and West Africa).

Brain Fag

West Africa-seen in students who have difficulties concentrating, remembering, and thinking-type of somatoform illness. Brain Fag syndrome. It occurs in parts of Africa. Low-grade stress syndrome encountered by students.

Dhat Syndrome

India/ SE Asia

F48/F45 neurotic disorders, somatoform autonomic

Seminal discharge results in a feeling of weakness called "Shenkui" in China: 40 drops of blood to create one drop of bone marrow and 40 drops of bone marrow to create a drop of sperm. It occurs in India with vague somatic symptoms and sexual dysfunction, attributed to semen passaging in urine because of excessive masturbation or intercourse.

Frigophobia-Pa-Leng or Pa-Feng

Morbid fear of feeling cold/ wind because of yin-yang imbalance-excessive yin leads to pa-leng or pa-Feng-Oriental men wrapping themselves up to avoid the cold and eating warm foods-pa-leng is fear of the cold-pa-Feng is fear of wind. We diagnose it under F40 specific phobias in the ICD-10.

Koro (turtlehead) Koro or Suo Yang. 

Malaysia, SE Asia

F48/45 neurotic disorder/somatoform autonomic dysfunction.

There are sudden episodes of intense anxiety in this condition that the penis will recede into the body and may cause death. It can cause epidemics. It occurs in Southeast Asia and China. The belief of genitals retracting and disappearing into the abdomen causes intense anxiety and fear of impending death.


Malaysia and Southeast Asia.

Middle-aged women

F48/44 neurotic/dissociative

Hypersensitivity to sudden fright, often with echopraxia, echolalia, obedience, dissociation, or trancelike behaviour. It occurs in Malay women. Following a frightening experience, the patient develops an exaggerated response to minimal stimuli with coprolalia, echolalia, and automatic obedience.

Mal de Ojo

The Mediterranean concept of the evil eye affects children with physical symptoms.

Nerfiza or Nerva

Egypt, Greece, and Central America. It presents with chronic episodes of extreme sorrow and anxiety-inducing somatic complaints such as headaches and muscle pain. It is more common in women treated with herbal teas.


F44: Dissociative disorders

-a dissociative episode with excitement often followed by seizures and coma lasting up to 12 hours. Maybe withdrawn before the attack and usual amnesia for the episode-may tear off clothing, jump in freezing water, eat faeces. Eskimo- Inuit. Piblokto, or arctic hysteria. It occurs in the Inuit population. It is more common in women, especially in winter. Characterised by hysterical behaviour, insensitivity to extreme cold, echolalia, depressive disorder, and coprophagia.


It occurs in Latin America. The subject believes they have lost their soul through a fight or other experience. F38/F45 neurotic disorder/somatoform autonomic-Latin America-attributed to a frightening event that causes the soul to leave the body and results in unhappiness and sickness.


"Nervous traits" in Japanese. A syndrome of obsessions, compulsive perfectionism, social withdrawal, extreme sensitivity, and neurasthenia.


F40.1/40.8 social phobia: Japanese psychiatric syndrome-fear of losing the goodwill of others because of imagined shortcomings in oneself. It can develop into anthropophobia or fear of people. 


It has 4 types: 

1. Sekimen kyofu: phobia of blushing.

2. Shubo-kyofu: Phobia of a deformed body.

3. Jikoshisen-kyofu: phobia of the eye to eye contact

4. Jikoshu-kyofu: A phobia of one's own foul body odour.

Ufufunyane (Amafufunyana)

Ufufunyane is a culture-bound syndrome, also described in the culture as a curse and a demonic possession. We see it in Zulu- and Xhosa-speaking communities in southern Africa. In Kenya, they refer to it as saka. It is an anxiety state attributed to the effects of magical potions, spirits, or demonic possession. It is common in Zulu people. Seen in Kenya and Southern Africa-anxiety states attributed to the effects of magical potions (given to them by rejected lovers) or spirit possession-characteristic sobbing, repeated neologisms, paralysis, trancelike states, or loss of consciousness in young, unmarried women who may also experience nightmares with sexual themes and rarely temporary blindness.


It involves an intense craving for human flesh and the fear that one will become a cannibal. They ascribe it to other psychiatric diseases. The patient believes they have undergone a transformation and become a cannibalistic monster. Clinicians see it in the Algonquian Indian cultures in North America. It occurs in North American Indians. 

F68: personality and behaviour. 


It occurs in Korea and means "fire sickness." It describes distress with accompanying somatic and emotional symptoms.




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