Cultural issues and psychiatric diagnosis: providing a general background for considering substance use diagnoses

To establish a general context on the topic of cross-cultural diagnosis and suggest how it can be applied to substance use disorders.

Critical reviews of the literature on psychiatric diagnosis, cross-cultural issues and the concept of ethnicity were conducted to provide a framework for making specific recommendations for substance use diagnoses.

Cross-cultural diagnosis remains in a state of flux. Key questions on ethnicity and psychopathology have not yet been fully answered by existing research. The broad use of the Diagnostic and Statistical Manual for Mental Disorders (DSM) system world-wide requires a careful look at its cross-cultural applicability.

For DSM-V, cultural/ethnic issues have to be clearly defined in clear terms that lend themselves to operational definitions. Recommendations should be research-based and testable. Meaningful cultural annotations and a glossary of cultural terms that are applicable in daily clinical practice and not limited to less frequently encountered syndromes (culture-bound) would be highly desirable.