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Understanding Schizophrenia Through Cultural Lenses in India: A Case Study Using the Cultural Formulation Interview.

Arif Ali¹, Fayaz Ahmad Paul², Abhijeet Singh³

¹Department of Psychiatric Social Work, Institute of Human Behaviour and Allied Sciences (IHBAS), New Delhi, India.

Issues in Mental Health Nursing

|January 23, 2026

Summary

The Cultural Formulation Interview (CFI) helps clinicians understand how cultural factors impact mental health. Using the CFI in a schizophrenia case improved understanding and adherence to treatment.

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Area of Science:

Psychiatry
Cultural Psychiatry
Mental Health Assessment

Background:

Sociocultural factors significantly influence mental health assessment and treatment.
Discrepancies in illness perceptions between patients and clinicians can impede effective care.
The DSM-5 Cultural Formulation Interview (CFI) offers a structured approach to evaluating these sociocultural influences.

Purpose of the Study:

To explore the utility of the CFI in a single-case study of schizophrenia.
To examine how cultural beliefs impact illness experience and treatment adherence.
To assess the role of sociocultural factors in a patient diagnosed with schizophrenia.

Main Methods:

A single-case study design was employed.
The DSM-5 Cultural Formulation Interview (CFI) was administered to a patient with schizophrenia and her caregiver.
Clinical interviews and ICD-10 diagnostic criteria were utilized.

Main Results:

The patient's family attributed her schizophrenia symptoms to supernatural causes, such as black magic, reflecting community beliefs.
Initial treatment involved faith healers, with psychiatric care leading to symptom improvement.
Cultural beliefs influenced the patient's understanding of her illness, leading to poor medication adherence despite psychiatric treatment.

Conclusions:

The CFI is valuable for gaining a comprehensive understanding of illness experiences by integrating cultural insights.
Incorporating cultural perspectives into clinical practice can enhance patient adherence and improve treatment outcomes.
Further research is needed to explore the clinical relevance and broader application of the CFI.