Revising psychiatric diagnostic categorisation of immigrant patients after using the Cultural Formulation in DSM-IV

This study evaluated the use of the Outline for Cultural Formulation (OCF) from the DSM-IV in the diagnosis of immigrants and refugee patients at an outpatient psychiatric clinic in Sweden. Using the OCF in conjunction with standard diagnostic procedures led to major revisions of diagnoses for 56.5%...

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Bibliographic Details
Published inTranscultural psychiatry Vol. 52; no. 3; pp. 287 - 310
Main Authors Bäärnhielm, Sofie, Åberg Wistedt, Anna, Rosso, Marco Scarpinati
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.06.2015
Subjects
Adult
Cultural Competency
cultural formulation
cultural psychiatry
Diagnostic and Statistical Manual of Mental Disorders
Emigrants and Immigrants - psychology
Ethnopsychology
Female
Humans
Interview, Psychological - methods
Male
Medicin och hälsovetenskap
Mental Disorders - diagnosis
Mental Disorders - ethnology
Middle Aged
migrants
psychiatric diagnosis
Refugees - psychology
Sweden - ethnology
cultural psychiatry
cultural formulation
psychiatric diagnosis
migrants
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Summary:This study evaluated the use of the Outline for Cultural Formulation (OCF) from the DSM-IV in the diagnosis of immigrants and refugee patients at an outpatient psychiatric clinic in Sweden. Using the OCF in conjunction with standard diagnostic procedures led to major revisions of diagnoses for 56.5% of patients. Anxiety disorders, especially PTSD, constitute the disorder group in which the most changes were made. In order to understand how information from the OCF interview led clinicians to revise diagnoses, data from clinical discussions were analysed through qualitative content analysis. This revealed four major themes related to the reevaluation, and at times confirmation, of given clinical psychiatric diagnoses: new information; expression of distress in emotional language; expression of distress in relation to life experiences; and improved understanding of the patient’s suffering. The findings suggest that the OCF may be useful for: (a) formulating culture in relation to illness experiences, (b) contextualising diagnostic categorisation, and (c) improving overall understanding of the patient that may facilitate individualised planning of treatment and therapy.
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ISSN:1363-4615
1461-7471
1461-7471
DOI:10.1177/1363461514560657