DSM-IV-TR includes a section on culture-bound syndromes, which are distinct patterns of emotional or behavioral disturbances that are found only in specific cultures.
- Ataque de Nervios: This is commonly found among Latin Americans, particularly those from the Caribbean. Ataques serve as a means of expressing intense emotional distress often following a disturbing event. Symptoms include uncontrollable shouting or crying, trance, aggressive verbal or physical behavior, trembling, or fainting. While ataques may be misdiag-nosed as a psychotic episode, they are probably more akin to a panic attack or a conversion disorder, which involves the expression of emotional distress through physical symptoms.
- Bouffee delirante: This syndrome is found in West Africa and in Haiti. It involves a sudden outburst of agitation and excitement, in which the person is confused, disoriented, and may complain of visual or auditory hallucinations (seeing or hearing things that are not there). This may be most similar to the DSM IV diagnosis of brief psychotic disorder.
- Koro: Fear of a Retracting Penis: This rather bizarre syndrome is found in South and East Asia, including China, Thailand, and India. The word koro is believed to be of Malaysian origin, but the syndrome has several different names across the region, including shook yang, shook yong, and suo yang in China, and jinjinia bemar in India. The syndrome is characterized by acute anxiety that the person’s genitals (including breasts in a woman) will retract into the body and even cause death. A somewhat similar fear of penis theft is found in parts of Africa. Although in the United States such a syndrome would be seen as a bizarre delusion, koro would be more accurately diagnosed as a conversion disorder.