# A Hispanic Female Presenting With the Cultural Syndrome “El Salto” as a Psychosomatic Symptom of Anxiety

## TL;DR

A Cuban-American woman's culturally specific somatic symptom 'el salto' was linked to anxiety and depression, highlighting the need for culturally aware diagnosis.

## Contribution

This case introduces 'el salto' as a psychosomatic expression of anxiety in Hispanic communities, emphasizing its clinical relevance.

## Key findings

- El salto is a culturally specific somatic expression of distress in Hispanic communities.
- Cultural Formulation Interview helped reveal the patient's long-standing anxiety and depression.
- Culturally embedded symptoms like el salto can delay diagnosis of treatable mental disorders.

## Abstract

“El salto” is a culturally embedded somatic expression of distress generally experienced as a sudden “jump” or churning in the upper abdomen. This phenomenon is common in Spanish-speaking Caribbean communities but is not formally recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); however, it parallels Hispanic cultural syndromes such as ataque de nervios, nervios, and susto. The present case describes an 87‑year‑old Cuban‑American woman with newly diagnosed Parkinson's disease who presented with moderate depression and anxiety assessed via Patient Health Questionnaire‑9 (score of 12) and General Anxiety Disorder‑7 (score of 11) and lifelong episodes of “el salto” during stress, which she and her community viewed as a normative cultural experience rather than a psychiatric symptom. Only through detailed questioning and the use of the Cultural Formulation Interview (a structured cultural psychiatric interview tool provided in the DSM-5) did she reveal that “el salto” had framed her understanding of distress since adolescence. Integration of her explanatory model with biopsychosocial insights led to a diagnosis of generalized anxiety disorder and major depressive disorder, and a treatment plan of escitalopram and bupropion was initiated. This case underscores how “el salto,” shaped by linguistic relativity and the influence of cultural norms on somatic expression, can delay recognition of treatable mood and anxiety disorders. Clinicians should routinely elicit culturally specific idioms of distress to avoid misdiagnosis, improve rapport, and deliver culturally responsive care. Future research should validate “el salto” across broader Hispanic cohorts and develop tailored screening tools.