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The Boston Globe

Ideas

Do some cultures have their own ways of going mad?

As psychiatry revises its manual of disorders, it faces a sticky question: what to do about “culture-bound syndromes”

Anyone who follows psychiatry has noticed that the field is now in the midst of a debate that galvanizes its members every 10 to 20 years. At the center of the hubbub is psychiatry’s most sacred text: the Diagnostic and Statistical Manual of Mental Disorders.

The DSM, for short, is a compendium of over 350 ways our minds can fail us, from autism to kleptomania to voyeurism. What makes it onto the list matters: The DSM’s definition of “mental illness” can dictate whether an insurance company covers a treatment, or even whether a murderer is fit to stand trial. With the American Psychiatric Association gearing up to revamp the manual for the first time since 1994, mental health specialists have begun jostling over some of the most divisive issues in the field: whether someone mourning the death of a loved one can be justifiably treated for depression, for instance, or whether overdiagnosis and a black market demand for Adderall have trumped up a false ADHD epidemic.

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