To the Editor:
Taijin kyofusho is described as a "culturally distinctive phobia in Japan" in DSM-IV. However, in the indigenous Japanese diagnostic system, depending on the content of the patients’ fear that they will displease or embarrass others,
taijin kyofusho is classified into four subtypes:
sekimen-kyofu (the phobia of blushing),
shubo-kyofu (the phobia of a deformed body),
jikoshisen-kyofu (the phobia of eye-to-eye contact), and
jikoshu-kyofu (the phobia of one’s own foul body odor)
+(1). Of these four subtypes,
sekimen-kyofu can reasonably be included in the category of social phobia, according to DSM-IV, since the fear of blushing is a common symptom.
Shubo-kyofu also fulfills the criteria for body dysmorphic disorder in DSM-IV. Thus, at this stage, the notion that
taijin kyofusho is a culture-bound syndrome cannot be held. Furthermore, although the remaining two subtypes,
jikoshisen-kyofu and
jikoshu-kyofu, cannot be adequately assigned to any of the diagnoses in the DSM-IV classification system, a literature review argues against this notion.