Cultural influences on diagnosis.

Contemporary child psychiatry has both embraced the relevance of culture to diagnosis (in endorsing cultural competence) and taken a largely culture-blind approach to classification (in adopting the Diagnostic and Statistical Manual of Mental Disorders-IV). Different kinds of diagnoses serve different purposes in child psychiatry: classification, understanding the child, and guiding intervention. All discourse about diagnosis is shaped by culture, especially aspects of culture that may be difficult to acknowledge. Integration of the role of culture into clinical practice is facilitated by balancing the use of categorical diagnoses with consensus-based assessment, including acknowledgment of the relative positions of clinician and child.