The DSM-IV Outline for Cultural Formulation (OCF) was a framework for assessment based on principles of cultural psychiatry. The Cultural Formulation Interview (CFI) for DSM-5 provided a tool enabling wider use of cultural formulation in clinical cultural assessment. Validation to justify the inclusion of the CFI in DSM-5 involved quantitative analysis of debriefing interviews of patients and clinicians for feasibility, acceptability and clinical utility. We now further examine qualitative field trial data from the CFI interviews and the debriefing interviews in Pune, India. Administration of the CFI was followed by routine diagnostic assessment of 36 psychiatric outpatients—11 found to have severe mental disorders (SMD) and 25 with common mental disorders (CMD). Domain-wise thematic analyses of the CFI and debriefing interviews identified recurrent themes based on cultural identity, illness explanatory models, stressful and supportive social relationships, and the impact of political, economic, and cultural contexts. A tendency to elaborate accounts, rather than simply name their problem, and more diverse past help-seeking distinguished CMD from SMD groups. Patients valued the CFI more than clinicians did, and most patients did not consider cultural background differences of clinician-patient relationships to be relevant. Qualitative analysis of CFI data and critical analysis of domain mapping of CFI content to the structure of OCF domains indicated the value of revising the dimensional structure of the OCF. A proposed revision (OCF-R) is expected to better facilitate clinical use and research on cultural formulation and use of the CFI.

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Conflict of Interest Disclosures: Dr Wool reported receiving personal fees from Diagnostica Stago. No other disclosures were reported.1. Information for health care providers using INR test meters in a clinical setting. US Food and Drug Administration website. Updated February 8, 2018. Accessed January 18, 2020. https://www.fda.gov/medical-devices/warfarin-inrtest-meters/information-health-care-providers-using-inr-test-meters-clinicalsetting 2. Donaldson M, Sullivan J, Norbeck A. Comparison of international normalized ratios provided by two point-of-care devices and laboratory-based venipuncture in a pharmacist-managed anticoagulation clinic.

Systemic lupus erythematosus (SLE) is the prototypical multisystem autoimmune disease with diverse clinical features in persons with disease. SLE is also unified by characteristic autoimmunity directed against nucleic acid or nucleoprotein complexes. SLE is both more prevalent and typically exhibits a more severe clinical course in persons with African-American ancestry than in persons with European ancestry. The reasons Abstracts