A 36-year-old woman of Chinese descent presents to the PMHNP after a referral from her primary care physician, who has worked up her physical complaints. These physical complaints include headaches, dizziness, and abdominal pain. The patient says she also experiences insomnia, difficulty concentrating, anxiety, and fatigue. These symptoms started approximately 6 months ago, after her husband had an affair, which he ended. She is also under stress at work, since she just received a promotion. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?

Choice A reason: Shenjing Shuairuo, commonly referred to as “neurasthenia” in Chinese culture, involves fatigue, insomnia, headaches, and difficulty concentrating, often in response to stress or interpersonal problems, matching this patient’s presentation. Choice B reason: Susto is a Latin American culture-bound syndrome associated with soul loss after a frightful event, typically not applicable to Chinese patients. Choice C reason: Kufungisisa, or “thinking too much,” is a Zimbabwean cultural syndrome involving rumination, but it is less culturally relevant to Chinese patients. Choice D reason: Khayal is a Southeast Asian syndrome associated with anxiety and palpitations, which does not correspond closely with this patient’s full symptom cluster.