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Utilization of Cultural Formulation Interview to Understand the Factors Affecting Treatment Adherence and Help-seeking in Mood Disorders: A Qualitative Study from Western India

Overview
Specialty Psychiatry
Date 2024 Mar 25
PMID 38523770
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Abstract

Introduction: Treatment adherence rates among patients of affective disorders remain sub-par across the world. Sociocultural factors affecting the same remain poorly understood. The current study aimed to explore and conceptualize the same.

Methodology: The study utilized a qualitative grounded and phenomenological approach study design. The patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders - Fifth edition (DSM-5) criteria of unipolar depression or bipolar affective disorder, and were presently under our treatment for at least three months and currently in remission, aged 18-60 years, and were able to understand Hindi or English, scored less than 6 on the Medication Adherence Rating Scale were included. Furthermore, key caregivers were also included in the study. Using purposive sampling and data saturation, a total of 30 participants were recruited. In-depth interviews were conducted using the cultural formulation interview as given in DSM-5, which was used as the interview tool. Thematic analysis of data was performed using Atlas.ti version 8.4.3.

Results: A total of 14 themes (deductive and inductive) emerging from 171 codes were identified. Some of the important inductive themes included cultural and societal attitude toward illness and treatment-seeking, trust, experience, and expectations from available health care, faith healing-related practices and beliefs. The implicit themes such as cultural understanding of the problem and cultural factors affecting help-seeking, also showed prudent findings.

Conclusion: The study findings demonstrate the various features of the sociocultural milieu and identity of an individual and family that have an influence on treatment-seeking behavior.

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