An outline for cultural formulation is provided by DSM-IV-TR, in order:
to supplement the multiaxial diagnostic assessment and to address difficulties that may be encountered in applying DSM-IV criteria in a multicultural environment. The cultural formulation provides a systematic review of the individual’s cultural background, the role of the cultural context in the expression and evaluation of symptoms and dysfunction, and the effect that cultural differences may have on the relationship between the individual and the clinician hellip; [I]t is important that the clinician take into account the individual’s ethnic and cultural context in the evaluation of each of the DSM-IV axes.
DSM-IV-TR
The cultural formulation suggested by DSM-IV-TR includes providing a narrative summary for each of the following categories:
• Cultural identity of the individual
• Ethnic or cultural reference group
• In the case of immigrants and ethnic minorities, if applicable, the degree of involvement with the culture of origin and with the host culture
• Language abilities, use and preference
• Cultural explanations of the individual’s illness
• Main ways in which symptoms or need for social support are communicated
• Any relevant culture-bound syndrome (see below)
• Cultural factors related to psychosocial environment and levels of functioning
• Culturally relevant interpretations of social stressors
• Social supports
• Levels of functioning
• Levels of disability
• Cultural elements of the relationship between the individual and the clinician, including any difficulty in
• Communicating in the patient’s first language
• Eliciting symptoms
• Understanding the cultural significance of the patient’s symptoms
• Negotiating an appropriate relationship or level of intimacy
• Determining if a behaviour is normal or pathological
• Overall cultural assessment for diagnosis and care.
PRESENTATION OF PSYCHIATRIC DISORDERS
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