The Psychiatric Formulation

Formulation consists in the process of developing a hypothesis about the origins of a person’s difficulties in the context of their relationships, social circumstances, life events, and the sense that they have made of them. It provides a structure for taking a global perspective on patient’s clinical condition. In psychiatric formulation, there are two equally important sources of information: the clinician – bringing knowledge derived from theory, research, and clinical experience – and the patient who has the expertise about his/her life and the meaning and impact of their relationships and circumstances. The psychiatric clinical formulation is widely accepted as a core component of clinical education in psychiatric training across the world. The skills required to construct a formulation include the ability to integrate and summarize the data and highlight the relevant predisposing, precipitating, perpetuating and protective factors for each individual patient. The psychiatric formulation goes beyond making a diagnosis, and it is essential for understanding patient’s clinical picture, etiology and management in the context of multi-dimensional bio-psycho-sociocultural domains.