This article discusses the experience of adapting and applying the Outline for a Cultural Formulation in DSM-IV to the Swedish context. Findings from a research project on the Cultural Formulation highlight the value of combining psychiatric nosological categorization with an understanding of patients’ cultural life context in order to increase the validity of categorization and to formulate individualized treatment plans. In clinical care practitioners need models and tools that help them take into account patients’ cultural backgrounds, needs, and resources in psychiatric diagnostic practice. We present a summary of a Swedish manual for conducting a Cultural Formulation interview. The need for further development of the Cultural Formulation is also discussed.
Al Saffar, S., Borgå, P., Wicks, S., & Hällström, T. (2004). The influence of the patients’ ethnicity, socio-demographic conditions and strain on psychiatric diagnosis given at an outpatient clinic. Nordic Journal of Psychiatry, 58(6), 421-427.
2.
Alarcón, R.D. ( 1995). Culture and psychiatric diagnosis. Impact on DSM-IV and ICD-10. Psychiatric Clinics of North America, 18(3), 449-465.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.
4.
Bäärnhielm, S. ( 2003). Clinical encounters with different illness realities. Qualitative studies of illness meaning and restructuring of illness meaning among two cultural groups of female patients in a multicultural area of Stockholm. Dissertation. Division of Psychiatry, Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
5.
Bäärnhielm, S. ( 2004). Restructuring illness meaning through the clinical encounter: A process of disruption and coherence. Culture, Medicine and Psychiatry, 28(1), 41-65.
6.
Bäärnhielm, S., Ekblad, S., Ekberg, J., & Ginsburg, B.E. (2005). Historical reflections on mental health care in Sweden: The welfare state and cultural diversity . Transcultural Psychiatry, 42(3), 394-419.
7.
Bäärnhielm, S., Scarpinati Rosso, M., & Pattyi, L. ( 2007) Kultur, kontext och psykiatrisk diagnostik. Manual för intervju enligt kulturformuleringen i DSM-IV. [Culture, context and psychiatric diagnosis. Manual for interviewing according to the Cultural Formulation in DSM-IV. Stockholm: Transkulturellt Centrum, Stockholms läns landsting. [in Swedish; English version on McGill University website, contact Eugene Raikhel ( eugene.raikhel@mcgill.ca)]
8.
Borgå, P. ( 1996). Psykopatologi utifrån ett kulturellt perspektiv . In P. Borgå, S. Bäärnhielm, S. Ekblad.Kulturell psykiatri. Föredrag från en konferens. (pp. 63-72) Stockholm: CPFU. [in Swedish]
9.
Cantor-Graae, E., Bøcker Pedersen, C., McNeil, T.F., & Bo Mortensen, P.B. (2003). Migration as a risk factor for schizophrenia: A Danish population-based cohort study. British Journal of Psychiatry, 182(2), 117-122.
10.
Cantor-Graae, E., & Selten, J.-P. ( 2005). Schizophrenia and migration: A meta-analysis and review . American Journal of Psychiatry, 162(1), 12-24.
11.
Dalman, C. ( 2007). Personal Communication, Epidemiology, Centre for Public Health, Forum.
12.
Ekblad, S. ( 2004). Migrants: Universal health services in Sweden . In J. Healy & M. McKee (Eds.) Health care: Responding to diversity (pp. 159-181). Oxford: Oxford University Press.
13.
Geertz, C. ( 1973). The interpretation of cultures: Selected essays . New York: Basic Books.
14.
Hjern, A., Wicks, S., & Dalman, C. ( 2004). Social adversity contributes to high morbidity in psychosis in immigrants: A national cohort study in two generations of Swedish residents . Psychological Medicine, 34(6), 1025-1033.
15.
International Guidelines for Diagnosis Assesment Workgroup, WPA. (2003). IGDA. Introduction. British Journal of Psychiatry, 182(S.45), 37-39.
16.
Kirmayer, L.J. ( 2001). Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62(S13), 22-30.
17.
Kirmayer, K.J. ( 2005). Culture, context and experience in psychiatric diagnosis . Psychopathology, 38(4), 192-196.
18.
Kleinman, A. ( 2005). How is culture important for DSM-IV? In J. Mezzich, A. Kleinman, H. Fabrega, & D. Parron , (Eds.), Culture & Psychiatric Diagnosis: A DSM-IV Perspective (pp. 15-25). Washington, DC: American Psychiatric Press.
19.
Kleinman A., & Benson, P. ( 2006). Anthropology in the clinic: the problem of cultural competency and how to fix it. Public Library of Science-Medicine , 3(10), 1673-1676.
20.
Leff, J. ( 1973). Culture and the differentiation of emotional states . British Journal of Psychiatry, 123(3), 299-306.
21.
Lewis-Fernández, R. ( 1996). Cultural formulation of psychiatric diagnosis . Culture, Medicine and Psychiatry, 20(2), 132-144.
22.
Manson, S.M. ( 2005). Culture and DSM-IV: Implications for the diagnosis of mood and anxiety disorders. In J. Mezzich , A. Kleinman, H. Fabrega, & D. Parron (Eds.), Culture & Psychiatric Diagnosis A DSM-IV Perspective (pp. 99-113). Washington, DC: American Psychiatric Press.
Mezzich, J.E., & Salloum, I.M. ( 2007). Editorial. Towards innovative international classification and diagnostic systems: ICD-11 and person-centred integrative diagnosis. Acta Psychiatrica Scandinavica, 116(1), 1-5.
25.
Omérov S. ( 2003). Kortfattad sammanställning av resultatet av en liten djupdykning i databasen på S:t Görans sjukhus. Norra Stockholms psykiatri. [in Swedish]
26.
Roth, G. ( 2006). A prospective study of mental health among mass-evacuated Kosovo Albanians. Dissertation, Karolinska Institutet, Stockholm, Sweden.
27.
Schieffelin, E.L. ( 1985). The cultural analysis of depressive affects: An example from New Guinea. In A. Kleinman and B. Good (Eds.), Culture and Depression: Studies in the Anthropology and Cross-cultural Psychiatry of Affect and Disorder (pp. 101-134). Berkeley: University of California Press.
28.
Silove, D., & Ekblad, S. ( 2002) How well do refugees adapt after resettlement in Western countries? Acta Psychiatrica Scandinavica, 106(6), 401-402.
29.
Sundquist, J., & Johansson, S.-E. (1997). Long-term illness among indigenous and foreign-born people in Sweden, Social Science and Medicine, 44(2), 189-198.
30.
Søndergaard, H.P. ( 2002). Post-traumatic stress disorder and life events among recently resettled refugees. Dissertation. Stockholm : Department of Public Health Sciences, Division of Psychosocial Factors and Health, Karolinska Institutet.
Zolkowska K., Cantor-Graae, E., & McNeil, T.F. (2001). Increased rates of psychosis among immigrants to Sweden: is migration a risk factor for psychosis? Psychological Medicine, 31(4), 669-678.
