Migration and its associated processes can produce considerable stress on those who are migrating as well as on those around them. Depression should be a common sequel of the process, but is not consistently found to be so. This paper reviews the literature and suggests that various vulnerability factors, including culture shock and changed cultural identity, can play a role in the genesis of depression. Clinicians must be aware of patterns of migration and resilience factors in order to plan any intervention strategies. Stresses due to political and economic factors will have differing influences on the mental state of individuals. One possible contribution may be a discrepancy between aspiration and achievement, which can result in poor self-esteem, leading to depression.

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Culture-bound syndromes were first described over 60 years ago. The underlying premise was that certain psychiatric syndromes are confined to specific cultures. There is no doubt that cultures influence how symptoms are perceived, explained and from where help is sought. Cultures determine what idioms of distress are employed to express distress. Rapid globalization and industrialization have made the world a smaller place and cultures are being more influenced by other cultures. This has led to social and economic changes in parts of the world where such syndromes were seen more frequently. In this review we illustrate these changes using the example of dhat syndrome (semen-loss anxiety). The number of syndromes in the DSM-5 has been reduced, acknowledging that these syndromes may be changing their presentations. Clinicians need to be aware of social and economic changes that may affect presentation of various psychiatric syndromes.

Nigeria is a large West African country, more than 900 000 km2 in area–nearly four times the size of the UK. Despite having a population of about 117 million people, 42% of whom live in cities, Nigeria has about half the population density of the UK. About a sixth of all Africans are Nigerian. The country has a diverse ethnic mix, with over 200 spoken languages, of which three (Yoruba, Hausa and Ibo) are spoken by about 60% of the population. The official language of government and educational instruction is English. There is a federal system of government and 36 states. Religious practice has a major role in Nigeria's culture; of the two main religions, Islam predominates in the northern part of the country and Christianity in the south. A large proportion of the population still embraces traditional religions exclusively, or interwoven with either Islam or Christianity.