Cultural Formulation of Mental Illness and Treatment Preferences Among Igbo, Hausa, and Yoruba Psychiatric Patients in Nigeria

Cultural factors profoundly shape illness attribution, symptom expression, and treatment preferences in psychiatric care. This comparative study examines cultural formulation of mental illness and treatment preferences among Igbo, Hausa, and Yoruba psychiatric outpatients recruited from tertiary hospitals in Enugu, Kano, and Ibadan respectively. A cross-sectional comparative design will recruit 60 patients from each ethnic group (total N=180) with confirmed mood disorder or psychosis diagnoses. The Cultural Formulation Interview (CFI) from DSM-5 will be adapted and administered in each indigenous language through trained clinical interviewers. Domains examined will include cultural identity, cultural conceptualization of distress, psychosocial stressors and cultural features, and cultural factors affecting coping. Qualitative content analysis will identify dominant cultural explanatory models by ethnic group, and chi-square tests will compare treatment preferences across groups. Evidence from comparative Nigerian studies suggests significant inter-ethnic variability in supernatural illness attribution, which directly predicts the choice of traditional healers over formal psychiatric care. Findings will contribute to culturally responsive psychiatric care frameworks and training programs for psychiatrists working in multi-ethnic Nigerian settings. Keywords: cultural formulation, mental illness, Igbo, Hausa, Yoruba, treatment preferences