Cultural assessment interview in the diagnosis of mental health: results from an international field trial in the Netherlands

Introduction. Issues related to the cultural conditioning of the psyche are receiving more and more attention due to the increase in the cultural diversity of society as a result of the intensified migration flows throughout the world in recent decades. As part of the editorial refinement of the ideas about the relationship between culture and psyche in DSM-V, the expert section on cross-cultural issues developed a Cultural Formulation Interview (CFI) of 16 questions, proposed to be used in the diagnosis of mental health. Complementing the DSM-V is the second edition of the Clinical Guide to Cultural Psychiatry, recently prepared by a team of authors. The manual has been prepared in accordance with the principles outlined in the DSM-V, which provides detailed instructions for the use of cultural interviews in diagnosis (Clinical Manual of Cultural Psychiatry, 2015). Objective: to determine the perception of CFI by patients (n=30) and clinicians (n=11) by parameters: convenience and ease of implementation, acceptability and clinical utility. The study was conducted as part of a large international clinical field trial in five countries. Earlier research has found that the ethnic diversity of the psychiatric population in the Netherlands tends to limit mental health communication and reduce the accuracy of psychiatric diagnosis. Semi-structured interviews were developed in the Netherlands with the aim of identifying cultural issues in psychodiagnostic assessment. Results. After training in the use of CFI as part of a structured program, 11 Dutch clinicians conducted 30 interviews in two groups: group 1 - patients of foreign origin, group 2 - native patients of the Netherlands. Clinicians and patients used quantitative and qualitative questionnaires before and after CFI prescription. The convenience, ease of implementation, and acceptability of the CFI were positively rated by patients and clinicians. Patients were more positive about the clinical utility of CFI compared to clinicians. Clinical use of CFI did not lead to a change in diagnoses of mental disorders due to the identical assessment of the level of mental health in different institutes in the Netherlands. Thus, CFI is a convenient and easy to implement, acceptable and potentially clinically useful tool in psychiatric practice. Its use expands the possibilities of standard psychiatric examination of patients with diagnostic and communication problems.