types that started out as cultural syndromes, and became widely accepted as a result of
their clinical and research utilit y. Across groups there remain  culturally patterned differ-
ences in symptoms, ways of talking about dist ress, and locally perceived causes, which are
in turn associated with coping strategies and patterns of help seeking.
Cultural concepts arise from local folk or  professional diagnost ic systems for mental
and emotional distress, and they may also re flect the influence of biomedical concepts.
Cultural concepts have four key featur es in relation to the DSM-5 nosology:
• There is seldom a one-to-one correspondence of any cultural concept with a DSM diag-
nostic entity; the correspondence is more lik ely to be one-to-many in either direction.
Symptoms or behaviors that might be sort ed by DSM-5 into several disorders may be
included in a single folk concept, and diverse presentations that might be classified by
DSM-5 as variants of a single disorder may be  sorted into several distinct concepts by an
indigenous diagnostic system.
• Cultural concepts may apply to a wide range of severity, including presentations that
do not meet DSM criteria for any mental disorder. For example, an individual with acute
grief or a social predicament may use the same idiom of distress or display the same
cultural syndrome as another individual  with more severe psychopathology.
• In common usage, the same cultural term frequently denotes more than one type of
cultural concept. A familiar example may be the concept of “depression,” which may
be used to describe a syndrome (e.g., major depressive disorder), an idiom of distress
(e.g., as in the common expression “I feel depressed”), or a perceived cause (similar to
“stress”).
• Like culture and DSM itself, cultural concepts  may change over time in response to both