In July 2012, the American Psychiatric Association (APA) closed its final commenting period on draft criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), slated for publication in May 2013. DSM-5 raises familiar questions about the cultural assumptions of proposed diagnoses, the scientific evidence base of these criteria and their validity in international settings. I review these issues since the publication of DSM-IV. I assess the cultural validity of DSM-5 and suggest areas of improvement.