Clinical Psychology Review, Vol. 18, No. 5, pp. 501–529, 1998 Copyright  1998 Elsevier Science Ltd Printed in the USA. All rights reserved 0272-7358/98 $19.00 + .00 PII S0272-7358(97)00107-4 CULTURE AND CLASSIFICATION: THE CROSS-CULTURAL APPLICATION OF THE DSM-IV Joanne Thakker and Tony Ward University of Canterbury ABSTRACT. Changes incorporated into the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) include a number of features designed to enhance its cross-cultural applicability. However, the overt move toward a culture-sensitive nosology is undermined by an implicit assumption of the universality of its primary syndromes. In this review we argue that the DSM -IV’s underlying thesis of universal- ity based on Western-delineated mental disorders is problematic and has limited cross-cultural applicability. Research on the cross-cultural manifestation of schizophrenia and depression shows that presentation of these disorders varies significantly across cultures. We conclude by discussing the research and clinical implications of these findings.  1998 Elsevier Science Ltd DEVELOPERS OF CLASSIFICATION systems ideally attempt to carve nature at its joints and to construct ways of grouping phenomena that reflect their natural state (Millon, 1991). Such systems represent a means of placing together disorders or enti- ties on the basis of their shared attributes or relations. A major difficulty in the psycho- pathology area is that there are a number of possible ways to group mental disorders or psychological problems; no one way is necessarily more natural than another. Func- tional classification is concerned with grouping together phenomena (e.g., problem behaviors) that are functionally equivalent (Hayes & Follette, 1992), while structural classification emphasizes the clustering of symptoms and signs that appear to cohere. For example, in the Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM-IV ; American Psychiatric Association, 1994). Despite ongoing disputes concern- ing the most appropriate system for categorizing mental disorders, one thing is clear: classification is indispensable for systematizing scientific observation and knowledge (Follette & Houts, 1996). It also enables clinicians and researchers to communicate about patients and guides treatment and research initiatives. The various versions of the DSM have played an important part in furthering our understanding of mental disorders, and in turn, defining them. Correspondence should be addressed to Tony Ward, Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand. E-mail: t.ward@psyc.canterbury. ac.nz 501