Conceptualizing Psychosis in Uganda

Teuton, Joanna; Bentall, Richard P.; Dowrick, Chris

doi:10.1177/1363461507074976

Cited by 35 publications

(16 citation statements)

References 38 publications

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“…Some examples include (a) communities that are more able to tolerate and protect consumers (e.g., within the Jamaican population) (34); (b) social solidarity by offering work opportunities in local businesses (e.g., tribal or village associations in Latin America) (35); (c) participation in traditional and religious healing rituals such as musical rituals in Sudanese culture (36); (d) more flexible job requirements (e.g., agrarian work within rural China) (37); (e) family and extended kinship or a communal network to support individuals with a mental disorder (e.g., kinship ties in Ethiopia and Tanzania) (38); and (f) attribution of cultural or spiritual value to psychotic experiences such as visions, or what might be interpreted as prophetic encounters (e.g., Uganda) (39). We propose that to most effectively implement anti-stigma interventions in LMICs, interventions might best leverage these existing strengths to combat the severe mental illness stigma and discrimination that occurs within these contexts.…”

Section: Resultsmentioning

confidence: 99%

Addressing Stigma Relating to Mental Illness in Low- and Middle-Income Countries

2015

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Section: Resultsmentioning

confidence: 99%

Addressing Stigma Relating to Mental Illness in Low- and Middle-Income Countries

2015

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“…Lay descriptions of psychotic disorders in Sub-Saharan Africa emphasize behavioural disturbance and disruption of social norms, yet do not often contain symptoms related to thought disturbance and perceptual symptoms [23-25]. The list of characteristics of people with ‘psychosis’, reported by respondents from four East African ethnic groups in a classical study by Edgerton [26], included: walking naked, being violent, arson, and talking nonsense.…”

Section: Discussionmentioning

confidence: 99%

Madness or sadness? Local concepts of mental illness in four conflict-affected African communities

et al. 2013

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BackgroundConcepts of ‘what constitutes mental illness’, the presumed aetiology and preferred treatment options, vary considerably from one cultural context to another. Knowledge and understanding of these local conceptualisations is essential to inform public mental health programming and policy.MethodsParticipants from four locations in Burundi, South Sudan and the Democratic Republic of the Congo, were invited to describe ‘problems they knew of that related to thinking, feeling and behaviour?’ Data were collected over 31 focus groups discussions (251 participants) and key informant interviews with traditional healers and health workers.ResultsWhile remarkable similarities occurred across all settings, there were also striking differences. In all areas, participants were able to describe localized syndromes characterized by severe behavioural and cognitive disturbances with considerable resemblance to psychotic disorders. Additionally, respondents throughout all settings described local syndromes that included sadness and social withdrawal as core features. These syndromes had some similarities with nonpsychotic mental disorders, such as major depression or anxiety disorders, but also differed significantly. Aetiological concepts varied a great deal within each setting, and attributed causes varied from supernatural to psychosocial and natural. Local syndromes resembling psychotic disorders were seen as an abnormality in need of treatment, although people did not really know where to go. Local syndromes resembling nonpsychotic mental disorders were not regarded as a ‘medical’ disorder, and were therefore also not seen as a condition for which help should be sought within the biomedical health-care system. Rather, such conditions were expected to improve through social and emotional support from relatives, traditional healers and community members.ConclusionsLocal conceptualizations have significant implications for the planning of mental-health interventions in resource-poor settings recovering from conflict. Treatment options for people suffering from severe mental disorders should be made available to people, preferably within general health care facilities. For people suffering from local syndromes characterized by loss or sadness, the primary aim for public mental health interventions would be to empower existing social support systems already in place at local levels, and to strengthen social cohesion and self-help within communities.

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“…It has been reported that people living in western countries focus mainly on biological and social risk factors such as genetic vulnerability, disease of the brain, infection or stressful social conditions or personal weakness [1-4], but the predominant views held by people living in non-western countries focus mainly on supernatural and religious factors [5-9]. In a cross-cultural study comparing Australia and Japan, infection, allergies and genetics were the most commonly attributed causes of mental illness reported in Australia; whereas, nervousness and perceived constitutional weakness were more often reported in Japan [3].…”

Section: Introductionmentioning

confidence: 99%

Perceived causes of severe mental disturbance and preferred interventions by the Borana semi-nomadic population in southern Ethiopia: a qualitative study

Teferra

Shibre

2012

BMC Psychiatry

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BackgroundCulture affects the way people conceptualize causes of severe mental disturbance which may lead to a variation in the preferred intervention methods. There is a seemingly dichotomous belief regarding what causes severe mental disturbance: people living in western countries tend to focus mainly on biological and psychosocial risk factors; whereas, in non-western countries the focus is mainly on supernatural and religious factors. These belief systems about causation potentially dictate the type of intervention preferred. Studying such belief systems in any society is expected to help in planning and implementation of appropriate mental health services.MethodsA qualitative study was conducted among the Borana semi-nomadic population in southern Ethiopia to explore perceived causes of severe mental disturbance and preferred interventions. We selected, using purposive sampling, key informants from three villages and conducted a total of six focus group discussions: three for males and three for females.ResultsThe views expressed regarding the causes of mental disturbance were heterogeneous encompassing supernatural causes such as possession by evil spirits, curse, bewitchment, ‘exposure to wind’ and subsequent attack by evil spirit in postnatal women and biopsychosocial causes such as infections (malaria), loss, ‘thinking too much’, and alcohol and khat abuse. The preferred interventions for severe mental disturbance included mainly indigenous approaches, such as consulting Borana wise men or indigenous healers, prayer, holy water treatment and seeking modern mental health care as a last resort.ConclusionsThese findings will be of value for health care planners who wish to expand modern mental health care to this population, indicating the need to increase awareness about the causes of severe mental disturbance and their interventions and collaborate with influential people and indigenous healers to increase acceptability of modern mental health care. It also provides information for further research in the area of mental health in this semi-nomadic population.

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Conceptualizing Psychosis in Uganda

Cited by 35 publications

References 38 publications

Addressing Stigma Relating to Mental Illness in Low- and Middle-Income Countries

Addressing Stigma Relating to Mental Illness in Low- and Middle-Income Countries

Madness or sadness? Local concepts of mental illness in four conflict-affected African communities

Perceived causes of severe mental disturbance and preferred interventions by the Borana semi-nomadic population in southern Ethiopia: a qualitative study

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