Abstract:
Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social
injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of
psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental
distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatry’s framing of ‘culturebound
syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African
context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by
apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models
that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces
in the manifestation of psychopathology.
