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.