Culture and Psychopathology

Culture – defined as generationally transmitted systems of knowledge, concepts, rules, and practices – is embedded in the social world and affects all aspects of individuals’ and families’ experience of mental illness and service utilization, including access to health care, patterning of symptoms, the models clinicians use to diagnose and investigate disorders, and patients’ expectations of care. To provide high-quality mental health services, it is important to understand the association between culture-related factors and psychopathology based on a bio-psycho-sociocultural health model. This chapter focuses on cultural variation in the expression and interpretation of mental disorders. Although ICD-11 and DSM-5 incorporated culture-relevant information to a greater degree than their predecessors, the extent of cultural variation in psychopathology remains challenging. Culture exerts a continuous effect on the form and content of psychiatric disorders, resulting in ever-changing variation across time and within and across ethnic, regional, and national settings. No fixed nosology can keep up with this variation; therefore, ICD-11 and DSM-5 must be continually adapted for every cultural context. Moreover, these diagnostic systems and evaluation measures emerge predominantly from Western settings; much more work needs to be done to incorporate experiences from other world regions. The integration of cultural, contextual thinking in mental health services is an ongoing task, with the goal of developing valid diagnostic approaches and effective clinical treatments.