This report attempts to provide a theoretical framework for exploring the intersection between current work in psychiatric nosology and cross-cultural psychiatry. Three positions at this intersection are constructed and contrasted--a clinical approach, an anthropological approach, and a synthetic clinical-anthropological approach. These positions are used to consider a number of cross-cultural issues in the forthcoming DSM-IV, including a background statement, a cross-cultural axis, diagnostic categories and criteria, and culture-bound syndromes.