A brief history is presented of the suggestions on personality disorde
rs (PDs) made by the NIMH-sponsored Culture and Diagnosis Group to APA
's DSM-IV Task Force. A quantitative analysis of the level of acceptan
ce of such suggestions in the final version of DSM-IV shows that, over
all, only 27.5% of them were included, This figure increases to 51% fo
r texts specifically related to 10 PD types, Paranoid and schizoid PD
texts included most of the Group's recommendations whereas those for n
arcissistic, histrionic, and avoidant were almost totally ignored, Con
ceptually, very important notions such as a cultural dimension, self-i
mage, acculturation, contextualization, exclusionary criteria, and dif
ferential diagnosis were omitted, The uneven presence of culture in th
e PDs section of DSM-IV calls for renewed efforts to increase research
, clinical observations, and theoretical discussions in order to make
the cultural perspective more visible and relevant in the national men
tal health debate.