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Psychiatric disorders in refugees and immigrants

In setting treatment goals, the patient’s cultural values and goals, as well as diagnosis, need to be considered by the clinician. Psychiatrists are urged to use the Cultural Formulation Interview of the DSM-5 to aide in assessing patients. With the impacts of globalization and ubiquitous television viewing influencing the culture of the refugees and immigrants, clearly their cultures are in flux and not static, after they arrive in the new country. Doctors and medical approaches are well known to refugees and immigrants. However, they may experience resistance and fear on referral to psychiatrists for reasons of stigma. A sensitive medical approach can help reduce the resistance and fear on the part of the refugee. When a relationship forms, psychosocial issues can be addressed. Treatment guidelines for evidence-based treatments for Western patients exist, but these should be individualized for refugees with individual goals. Good clinical practice and cultural understanding must meet the patient’s personal goals.