Ramírez Stege Alyssa M, Yarris Kristin Elizabeth
University of Wisconsin-Madison.
University of Oregon.
Transcult Psychiatry. 2017 Aug;54(4):466-487. doi: 10.1177/1363461517716051. Epub 2017 Jul 10.
While the classification of psychiatric disorders has been critiqued for failing to adequately account for culture, the inclusion of the Cultural Formulation Interview (CFI) in the DSM-5 has been viewed as a promising development for the inclusion of cultural factors in diagnosis and treatment of mental illness. In this study, we assess the appropriateness, acceptability, and clinical utility of the CFI among outpatients in a Mexican psychiatric hospital. Our assessment included observations of psychiatric residents' application of the CFI with 19 patients during routine outpatient visits, along with pre- and post-CFI interviews to determine providers' and patients' views of the CFI. The CFI was generally well received by providers and patients, viewed as a way of building trust and increasing providers' understanding of contextual factors influencing mental illness, such as social support. However, the CFI questions specifically related to "culture" were of limited effect and both patients and providers did not view them as useful. We discuss implications for the clinical assessment of cultural factors influencing mental health and illness and for the incorporation of the CFI in Mexican clinical settings.
虽然精神疾病的分类因未能充分考虑文化因素而受到批评，但《精神疾病诊断与统计手册》第五版（DSM - 5）中纳入文化定式访谈（CFI）被视为在精神疾病诊断和治疗中纳入文化因素的一个有前景的进展。在本研究中，我们评估了CFI在一家墨西哥精神病医院门诊患者中的适用性、可接受性和临床效用。我们的评估包括观察精神科住院医师在常规门诊就诊期间对19名患者应用CFI的情况，以及在CFI前后进行访谈，以确定提供者和患者对CFI的看法。CFI总体上受到提供者和患者的好评，被视为建立信任以及增强提供者对影响精神疾病的背景因素（如社会支持）理解的一种方式。然而，与“文化”具体相关的CFI问题效果有限，患者和提供者都不认为它们有用。我们讨论了对影响心理健康和疾病的文化因素进行临床评估以及在墨西哥临床环境中纳入CFI的意义。
