What is formulation in psychiatry?

When assessing the same patient, two experts may produce two similar summaries, but two different formulations. This is the fundamental difference: a summary is descriptive, whereas a formulation is analytical and evaluative… formulating a case with clarity and precision is probably the most testing yet challenging and crucial part of a psychiatric assessment

The Maudsley Handbook of Practical Psychiatry, Reference Owen, Wessely and Murray2014

This paper by Gareth Owen has been published in Psychological Medicine. The abstract says:

“The practice of formulation has been both championed and severely criticised within clinical psychiatry and interest in formulation within the teaching of clinical psychiatry is at a low ebb. This article traces the history of the biopsychosocial model, the concept of diagnostic hierarchy and the role of ‘verstehen’ (or intersubjective meaning grasping) in the clinical assessment. All three of these concepts are considered relevant to the practice of formulation. Responding to challenges aimed at these concepts, it argues that formulation in psychiatry needs resuscitating and rethinking and provides some recommendations for a practice of formulation fit for the 21st century.”

You can read the whole paper from here.

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