title: Clinical value of the cultural formulation interview in Pune, India.
abstract: BACKGROUND
  Development of the cultural formulation interview (CFI) in DSM-5 required validation for cross-cultural and global use.
  
  
  OBJECTIVE
  To assess the overall value (OV) of CFI in the domains of feasibility, acceptability, and utility from the vantage points of clinician-interviewers, patients and accompanying relatives.
  
  
  METHODS
  We conducted cross-sectional semi-structured debriefing interviews in a psychiatric outpatient clinic of a general hospital.
  
  
  METHODS
  We debriefed 36 patients, 12 relatives and eight interviewing clinicians following the audio-recorded CFI. We transformed their Likert scale responses into ordinal values - positive for agreement and negative for disagreement (range +2 to -2).
  
  
  METHODS
  We compared mean ratings of patients, relatives and clinician-interviewers using nonparametric tests. Clinician-wise grouping of patients enabled assessment of clinician effects, inasmuch as patients were randomly interviewed by eight clinicians. We assessed the influence of the presence of relatives, clinical diagnosis and interview characteristics by comparing means. Patient and clinician background characteristics were also compared.
  
  
  RESULTS
  Patients, relatives and clinicians rated the CFI positively with few differences among them. Patients with serious mental disorders gave lower ratings. Rating of OV was lower for patients and clinicians when relatives were present. Clinician effects were minimal. Clinicians experienced with culturally diverse patients rated the CFI more positively. Narratives clarified the rationale for ratings.
  
  
  CONCLUSIONS
  Though developed for the American DSM-5, the CFI was valued by clinicians, patients and relatives in out-patient psychiatric assessment in urban Pune, India. Though relatives may add information and other value, their presence in the interview may impose additional demands on clinicians. Our findings contribute to cross-cultural evaluation of the CFI.
authors: Department of Medicine, Psychiatry Unit, KEM Hospital, Pune and KEM Hospital Research Centre, Pune, Maharashtra, India.
authors: Vasudeo P
authors: VP
authors: Paralikar
authors: Department of Psychiatry, Maharashtra Institute of Mental Health, Pune, Maharashtra, India.
authors: Sanjeev B
authors: SB
authors: Sarmukaddam
authors: Department of Medicine, Psychiatry Unit, KEM Hospital, Pune and KEM Hospital Research Centre, Pune, Maharashtra, India.
authors: Kanak V
authors: KV
authors: Patil
authors: Department of Medicine, Psychiatry Unit, KEM Hospital, Pune and KEM Hospital Research Centre, Pune, Maharashtra, India.
authors: Amit D
authors: AD
authors: Nulkar
authors: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland.
authors: Mitchell G
authors: MG
authors: Weiss
keywords: Acceptability; clinician-effects; cultural formulation interview; debriefing; feasibility; influence of relatives; utility
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