  DSM-5 supplements this conceptual reform with a thorough overhaul of the “Outline for Cultural Formulation”. This is an interview outline introduced in DSM-IV-TR, in part in response to pleas from cross-cultural psychiatrists dissatisfied with the old ways (e.g. Canino and Alegria 2008). It reflects an unprecedented investment in applying anthropology to psychiatry by the DSM-5 Cultural Issues Subgroup, who ran field trials of the new Cultural Formulation Interview (CFI) in 6 sites around the world (Aggarwal 2013). The CFI is designed to assess both the cultural or ethnic groups that the subject belongs to and the ways in which those groups understand the problem and affect the subject’s experience of it. It comprises a series of questions designed to gather information from the point of view of the patient and his or her cultural peers, including specific questions that tell the patient not to repeat what the doctor has told them but to express their problems as they see them and describe which aspects of their identity are most important to them. It could be used with any subject anywhere, and the manual acknowledges that all mental illness, including the DSM diagnoses, is shaped by the surrounding culture. On the other hand, the CFI and its associated conceptual material are poorly integrated into the DSM-5 – many diagnoses pay no attention to cultural formulation at all – and the culture-bound syndromes do in fact survive. They have been renamed “Cultural Concepts of Distress” but the appendix listing them survives, so one may wonder how thorough the overhaul has been.