From amok to susto
Increased migration and digital connectivity mean healthcare providers and the public are interacting across cultures more than ever. Understanding culture will help preventing misdiagnosis. Some people still think that these syndromes are “fake” or “exotic” as they may not fit neatly into Western medical categories.
The Diagnostic and Statistical Manual of Mental Disorder (DSM-5) includes some rare psychiatric syndromes that tend to manifest in certain cultures or regions of the world, previously known as “culture-bound syndromes“. These syndromes are included under “cultural concepts of distress” in DSM-5. This updated approach is intended to characterize cultural influences more accurately on the expression and experience of mental disorders.
Amok/Berseker
Loosely translated as “rampage” in Malay, it is marked by unpremeditated violence, disorderly or homicidal rage directed against other objects or persons. It is often accompanied by amnesia and exhaustion. The diagnosis is found in Southeast Asia and Scandinavia.
Wind Attacks
Found in Cambodia and Cambodian immigrants, and new to DSM-5, it is characterized by dizziness, increased heart rate, anxiety and autonomic arousal. It can be related to panic attacks and trauma related disorders. The name comes from the theory that symptoms are due to a wind-like substance rising in the body.
Latah
Diagnosed in Southeast Asia and Japan, it describes an exaggerated startle response to frightening stimuli. A similar condition, termed “jumping Frenchman of Maine” syndrome, has been described by Franco-Canadian lumberjack communities. It can be a severe form of shock in response to a sudden or severe traumatic event.
Kufungsia/Thinking too much
It is a disorder of distress found in Zimbabwe especially in patients with HIV. The symptoms are similar to anxiety, panic disorders, and depression, such as stress, pain, a lack of hope, and suicidal thoughts. An example of what patients might say is “my heart is painful because I think too much”.
Piblokto
Also known as “Arctic hysteria”, it describes a condition where patients experience prolonged, extreme excitement ranging from property destruction to stripping naked, sometimes followed by seizures, delirium, and coma. It is found in Arctic and Subarctic Inuit. This condition could result from Vitamin D deficiency through lack of sunlight or Vitamin A toxicity from eating the livers of Arctic animals such as polar bears, seals and walruses which contain high levels of Vitamin A.
Malady Moun/Humanly caused illness
Malady Moun is found in Haitian communities and is seen as an explanation for many medical and psychiatric syndromes. Patients thought their illness is “sent” by others out of envy and hatred, and can describe psychosis, depressive symptoms, and even academic or social problems. It sometimes mixed with magical beliefs and overvalued ideas.
Taijin Kyofusho
This diagnosis is found in Japan. Patients experience extreme self-consciousness regarding their appearance and suffer from intense, disabling fear that their bodies are embarrassing or offensive to others.
Shin-byung
Shin-byung is a folk diagnosis in Korea characterized by anxiety, weakness, dizziness, and gastrointestinal symptoms. Patients often attribute their state to possession by ancestral spirits.
Susto
It refers to the soul leaving the body in response to a frightening experience. It is diagnosed in certain Latino populations. It can also be related to post traumatic stress disorder /PTSD.
Gururumba
It is a diagnosis from New Guinea that describes an episode in which patients – usually a married man – begins burglarizing neighbouring homes, taking objects which he considers valuable, but which seldom are. He then runs away, often for days, returning without the objects and amnestic about the episode. The patient is hyperactive, clumsy, and with slurred speech.
These syndromes can be experienced by anybody thus increasing relevance in clinical practice especially in multicultural communities, given they are still reported in many cultures around the world. As we look toward a more inclusive 2026, knowledge of these syndromes builds a bridge between traditional wisdom and modern clinical science.
Dr. Yenny Vandalita is a G.P. with two decades of clinical experience who has moved beyond traditional clinical treatment to focus on the holistic wellbeing of patients, championing the idea that health is a proactive partnership rather than a reactive process. She is a firm believer in the power of patient education and medical literacy.
