The culture of a particular population is the sum of work and thought expressed or
produced by members of that population, including their social practices, beliefs,
institutions, and arts.7 Although it is a reflection of people and the ecological and
socioeconomic contexts in which they live, at the same time culture exerts a profound
influence on individual behaviour, cognition and emotion.8
Culture can play an important role in the development and expression of mental disorder
through pathogenic or pathoplastic mechanisms. While some mental disorders have a strong
pan‐cultural core (high degree of syndromal stability across cultures), others are specific or
unique to a particular culture (culture‐bound syndromes).
Examples of culture‐bound syndromes:
• Amok. Occurs in Malays and consists of a period of withdrawal, followed by a
sudden outburst of homicidal aggression in which the sufferer will attack anyone
within reach. The attack typically lasts for several hours until the sufferer is
overwhelmed or killed. If alive, the person typically passes into a deep sleep or
stupor for several days, followed by amnesia for the event. It almost always occurs in
men.
• Koro. Common in South‐east Asia and China. Involves the belief of genital retraction
with disappearance into the abdomen, accompanied by intense anxiety and the fear
of impending death.


• Dhat. Commonly recognised in Indian culture. Includes vague somatic symptoms
and sometimes sexual dysfunction which the subject attributes to the passing of
semen in urine as a consequence of excessive indulgence in masturbation or
intercourse.
• Windigo. Described in North American Indians, and ascribed to depression,
schizophrenia, hysteria or anxiety. It is a disorder in which the subject believes he or
she has undergone a transformation and become a monster who practises
cannibalism.
• Latah. Usually begins after a frightening experience in Malay women. It is
characterised by a response to minimal stimuli with exaggerated startles, coprolalia,
echolalia, echopraxia and automatic obedience.
• Brain fag syndrome. Widespread low‐grade stress syndrome described in many
parts of Africa, commonly encountered among students.
• Pibloktoq or Artic hysteria is a culture bound syndrome appearing exclusively in
Eskimos (Inuit) living within the Arctic Circle. It is more common in woman and
tends to occur in winters. It is characterised by hysterical behaviours (screaming or
uncontrolled behaviours), insensitivity to extreme cold, echolalia, depression and
coprophagia. Often there is amnesia for the episode. It has been explained by a
variety of theories: ecological, nutritional, biological‐physiological, psychologicalpsychoanalytic,
social structural and cultural, and possible implication of vitamin
intoxication, namely, hypervitaminosis A.