tain panic disorder or health anxiety). Cultural meanings, habits, and traditions can also
contribute to either stigma or support in the social and familial response to mental illness.
Culture may provide coping strategies that enhance resilience in response to illness, or sug-
gest help seeking and options for accessing heal th care of various types, including alterna-
tive and complementary health systems. Culture may influence acceptance or rejection of a
diagnosis and adherence to treatments, affecting the course of illness and recovery. Culture
also affects the conduct of the cl inical encounter; as a result, cultural differences between the
clinician and the patient have implications fo r the accuracy and acceptance of diagnosis as
well as for treatment decisions, prognost ic considerations, and clinical outcomes.
Historically, the construct of the culture- bound syndrome has been a key interest of
cultural psychiatry. In DSM-5, this construct h as been replaced by three concepts that offer
greater clinical utility: 
1.Cultural syndrome  is a cluster or group of co-occurr ing, relatively invariant symptoms
found in a specific cultural gr oup, community, or context (e.g., ataque de nervios ). The
syndrome may or may not be recognized as an  illness within the culture (e.g., it might
be labeled in various ways), but such cultural patterns of distress and features of illness
may nevertheless be recognizab le by an outside observer. 
2.Cultural idiom of distress  is a linguistic term, phrase, or  way of talking about suffering
among individuals of a cultural group (e.g.,  similar ethnicity and religion) referring to
shared concepts of pathology and ways of  expressing, communicating, or naming es-
sential features of distress (e.g., kufungisisa ). An idiom of distress need not be associated