TY - JOUR T1 - Depression as a culture-bound syndrome: implications for primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 229 LP - 230 DO - 10.3399/bjgp13X665189 VL - 63 IS - 610 AU - Christopher Dowrick Y1 - 2013/05/01 UR - http://bjgp.org/content/63/610/229.abstract N2 - This month sees the publication of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Headline features include new diagnostic categories of anxious depression and somatic symptom disorder, and blurring of boundaries between grief and depressive disorder. However its relevance to primary care may be less than anticipated.According to its predecessor, DSM-IV, culture-bound syndromes are indigenously considered to be ‘illnesses’, limited to specific societies or culture areas, composed of localised diagnostic categories, and used to frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observations.1 Examples commonly cited include koro in eastern Asia, latah in Malaysia, and ataque de nervios in Latin America.It can be argued that depression also fulfils the criteria for a culture-bound syndrome, in westernised societies.Our indigenous beliefs are based on the premise that depression is an illness of common and increasing prevalence, destined to become the second most disabling disease by 2020. These beliefs have societal and cultural limitations. They predominate in anglophone societies, although there is wide variation in their understanding and acceptance within these societies, depending on class, gender and culture.2 Depression can therefore be understood as a set of localised diagnostic categories, albeit currently operating on a larger scale than other culture-bound syndromes.If depression as a diagnostic category had validity and utility, it could be seen as a universal, transcultural concept. But it … ER -