The principal mental health diagnostic classifications are found in the International Classification of Diseases (ICD) of the World Health Organization (www.who.int/classifications/icd/en) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (www.psych.org/practice/dsm). The DSM was initially developed to create a common system of nomenclature, and the objective of subsequent iterations was the identification of maximally valid diagnostic criteria according to a specific classificatory system. Both the DSM and the ICD systems (despite the ostensible international focus of the latter) are fundamentally based in European and North American thinking (Kleinman, 1988). Western diagnostic systems can be understood in the way that structural anthropology conceptualises scientific classification: ‘classificatory schemes […] allow the natural and social universe to be grasped as an organized whole’ (Levi-Strauss, 1966: p. 135).

As a manner of observing the universe, classifications of mental disorders are necessarily immersed in a culture-specific context, which clearly complicates the possibility of their universal application (Heidegger, 2000). Growing multiculturalism demands questioning of the pertinence of these classification systems in non-Western environments. The consequences of generalising data derived from these systems is itself questionable and requires attention (Beneduce, 2006). Three epistemological positions can be distinguished in relation to the question of the validity and/or usefulness of Western diagnostic systems for individuals from non-Western cultures:

Classification as universally applicable

The first approach is the most common and shared by mainstream psychiatry. The DSM represents one of the best known systems for the universalisation of psychiatric entities to other cultures (Kupfer et al, 2008; Yeung & Kam, 2008).