A 16-year-old girl of South Asian descent presents to the PMHNP accompanied by her father. He reports that since the death of her mother months ago, his daughter has been having episodes of strange behavior. He describes these episodes as beginning with a stomach ache and dizziness. Then she behaves as though her dead mother has taken control of her body. After a few minutes, she is back to herself again. Afterward, the patient states she cannot remember anything about these episodes. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?

Choice A reason: Amok is a sudden outburst of aggressive behavior followed by amnesia, often seen in Southeast Asian males. This patient’s presentation does not include aggression and is not male-specific, making Amok less likely. Choice B reason: Khayal attacks involve panic-like symptoms with palpitations, dizziness, and anxiety, common in Southeast Asian cultures. While some overlap exists, the episodic possession-like behavior is more indicative of possession syndrome. Choice C reason: Possession syndrome involves episodes where the individual acts as though another entity has taken control, often with amnesia for the event. This aligns with the patient’s experience following her mother’s death. Cultural beliefs may shape the expression of stress and grief. Choice D reason: Ataque de nervios is a cultural syndrome characterized by emotional outbursts, crying, trembling, or aggression, mainly described in Latin American populations. The patient’s presentation does not match this syndrome.