  DSM-5 has moved away from concept of a culture-bound syndrome and adopted that of “cultural concepts of distress” (p.758). These are ways in which “cultural groups experience, understand and communicate suffering, behavioural problems or troublesome thoughts and emotions”. DSM-5 distinguishes three main types of cultural concepts: syndromes, idioms (ways of expressing distress), and local explanations. The last is particularly interesting: a standard picture of mental illness in both non-Western and premodern societies represents it as explained by supernatural forces like ghost possession. But Edgerton (1966) reported that the East African tribes he studied were divided over the explanation of psychosis. Some tribes did understand it in terms of ghost possession, but others thought of it as having an organic cause (“brain worms”). DSM-5 makes room for such findings as part of the integration of local explanations into a theory of mental illness.