DSM-IV

A culturally distinctive phobia in Japan, in some ways resembling Social Phobia in DSM-IV. This syndrome refers to an individual's intense fear that his or her body, its parts or its functions, displease, embarrass, or are offensive to other people in appearance, odor, facial expressions, or movements. This syndrome is included in the official Japanese diagnostic system for mental disorders.

DSM-5

Taijin kyofusho ("interpersonal fear disorder" in Japanese) is a cultural syndrome characterized by anxiety about and avoidance of interpersonal situations due to the thought, feeling, or conviction that one's appearance and actions in social interactions are inadequate or offensive to others. In the United States, the variant involves having an offensive body odor and is termed olfactory reference syndrome. Individuals with taijin kyofusho tend to focus on the impact of their symptoms and behaviors on others. Variants include major concerns about facial blushing (erythrophobia), having an offensive body odor (olfactory reference syndrome), inappropriate gaze (too much or too little eye contact), stiff or awkward facial expression or bodily movements (e.g., stiffening, trembling), or body deformity.

Taijin kyofusho is a broader construct than social anxiety disorder in DSM-5. In addition to performance anxiety, taijin kyofusho includes two culture-related forms: a "sensitive type," with extreme social sensitivity and anxiety about interpersonal interactions, and an "offensive type," in which the major concern is offending others. As a category, taijin kyofusho thus includes syndromes with features of body dysmorphic disorder as well as delusional disorder. Concerns may have a delusional quality, responding poorly to simple reassurance or counterexample.

The distinctive symptoms of taijin kyofusho occur in specific cultural contexts and, to some extent, with more several social anxiety across cultures. Similar syndromes are found in Korea and other societies that place a strong emphasis on the self-conscious maintenance of appropriate social behavior in hierarchical interpersonal relationships. Taijin kyofusho-like symptoms have also been described in other cultural contexts, including the United States, Australia, and New Zealand.

Related conditions in other cultural contexts

Taein kong po in Korea.

Related conditions in DSM-5

Social anxiety disorder, body dysmorphic disorder, delusional disorder, obsessive-compulsive disorder, olfactory reference syndrome (a type of other specified obsessive-compulsive and related disorder). Olfactory reference syndrome is related specifically to the jikoshu-kyofu variant of taijin kyofusho, whose core symptom is the concern that the person emits an offensive body odor. This presentation is seen in various cultures outside Japan.

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