The content of delusions in a sample of South African Xhosa people with schizophrenia

Campbell, Megan M.; Sibeko, Goodman; Mall, Sumaya; Baldinger, Adam; Nagdee, Mohammed; Süsser, Ezra; Stein, Dan J.

doi:10.1186/s12888-017-1196-3

Cited by 35 publications

(26 citation statements)

References 40 publications

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“…For some individuals, different threats may be more salient or more likely and this might well be reflected in the content of delusions across individuals (e.g. see (96)). Secondly, we suggest additional focus is needed on how people perceive social groups, including processes relating to identification with in-group and categorising others as out-group, and how these processes may be altered in people experiencing severe paranoia.…”

Section: Discussionmentioning

confidence: 99%

An evolutionary perspective on paranoia

Raihani¹,

Bell²

2018

Preprint

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Although paranoia is the most commonly presenting symptom of psychosis, paranoid thoughts occur frequently in the general population and range widely in severity, from mild socio-evaluative concerns to frank delusions about the harmful intentions of others. Furthermore, paranoia commonly appears after a surprisingly diverse range of difficulties including trauma, brain injury, sleep deprivation, drug use, and psychiatric and neurological disorder. Evolutionary accounts of paranoia have been proposed before but have largely focused on paranoia as a misplaced threat response. Although social threat is clearly a key component, the experience of paranoia is markedly more complex than these accounts would lead us to believe: paranoia can involve multiple alterations in the perception of the social environment, the identification of specific but seemingly arbitrary groups as the source of persecution, and extended beliefs about conspiracy and complex coordination between the perceived persecutors. Here, we argue for an evolutionary approach to paranoia that more fully accounts for its complex social phenomenology and considers how it can be understood in light of our evolved social cognition. More specifically, in terms of the ability to form coalitions and coordinate between groups in situations of cooperation and competition.

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Section: Discussionmentioning

confidence: 99%

An evolutionary perspective on paranoia

Raihani¹,

Bell²

2018

Preprint

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“…People used to use witchcraft by practising exoteric rites with the assistance of hallucinogenic substances, “which are themselves basically forces of destruction” [ 73 – 74 ][ 75 – 76 ]. Campbell [ 77 ] found that some Xhosa patients in South Africa who were diagnosed with schizophrenia attributed their mental illness to witchcraft and stated that they were possessed by an internal force, displaying a passive attitude and describing hallucinations [ 78 ][ 79 – 80 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the knowledge, explanatory models of illness, and patterns of healthcare-seeking behaviour of Fang culture-bound syndromes in Equatorial Guinea

et al. 2018

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In 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) included “culture-bound syndromes” in its classification of psychiatric disorders and associated them with disease processes that manifest in behavioural or thought disorders that develop within a given cultural context. This study examines the definitions, explanatory models, signs and symptoms, and healthcare-seeking behaviours common to Fang culture-bound syndromes (i.e., kong, eluma, witchcraft, mibili, mikug, and nsamadalu). The Fang ethnic group is the majority ethnic group in Equatorial Guinea. From September 2012 to January 2013, 45 key Fang informants were selected, including community leaders, tribal elders, healthcare workers, traditional healers, and non-Catholic pastors in 39 of 724 Fang tribal villages in 6 of 13 districts in the mainland region of Equatorial Guinea. An ethnographic approach with an emic-etic perspective was employed. Data were collected using semi-structured interviews, participant observation and a questionnaire that included DHS6 key indicators. Interviews were designed based on the Cultural Formulation form in the DSM-5 and explored the definition of Fang cultural syndromes, symptoms, cultural perceptions of cause, and current help-seeking. Participants defined “Fang culture-bound syndromes" as those diseases that cannot be cured, treated, or diagnosed by science. Such syndromes present with the same signs and symptoms as diseases identified by Western medicine. However, they arise because of the actions of enemies, because of the actions of spirits or ancestors, as punishments for disregarding the law of God, because of the violation of sexual or dietary taboos, or because of the violation of a Fang rite of passage, the dzas, which is celebrated at birth. Six Fang culture-bound syndromes were included in the study: 1) Eluma, a disease that is targeted at the victim out of envy and starts out with sharp, intense, focussed pain and aggressiveness; 2) Witchcraft, characterized by isolation from the outside, socially maladaptive behaviour, and the use of hallucinogenic substances; 3) Kong, which is common among the wealthy class and manifests as a disconnection from the environment and a lack of vital energy; 4) Mibili, a possession by evil spirits that manifests through visual and auditory hallucinations; 5) Mikug, which appears after a person has had contact with human bones in a ritual; and 6) Nsamadalu, which emerges after a traumatic process caused by violating traditions through having sexual relations with one’s sister or brother. The therapeutic resources of choice for addressing Fang culture-bound syndromes were traditional Fang medicine and the religious practices of the Bethany and Pentecostal churches, among others. Among African ethnic groups, symbolism, the weight of tradition, and the principle of chance in health and disease are underlying factors in the presentation of certain diseases, which in ethno-psychiatry are now referred to as culture-bound syndromes. In this study, traditional heal...

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“…The H3Africa SAX study, which aims to identify genes responsible for schizophrenia, has not yet reported on genetic findings. However, the study has contributed a number of papers on schizophrenia symptomatology, 13 community engagement, 14 and ethical issues. For example, given previous work on the relationship between schizophrenia and cultural beliefs, we undertook a study of the content of delusions in a subsample of participants.…”

Section: Preliminary Discoveries From Genomic Research In H3africamentioning

confidence: 99%

“…This explanation aligns well with the understanding of jealousy-induced witchcraft in southern African communities, and highlights the important role that culture plays in the content of delusions. 13 …”

Section: Preliminary Discoveries From Genomic Research In H3africamentioning

confidence: 99%

H3Africa: current perspectives

Mulder¹,

Abimiku²,

Adebamowo³

et al. 2018

PGPM

150

112

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Precision medicine is being enabled in high-income countries by the growing availability of health data, increasing knowledge of the genetic determinants of disease and variation in response to treatment (pharmacogenomics), and the decreasing costs of data generation, which promote routine application of genomic technologies in the health sector. However, there is uncertainty about the feasibility of applying precision medicine approaches in low- and middle-income countries, due to the lack of population-specific knowledge, skills, and resources. The Human Heredity and Health in Africa (H3Africa) initiative was established to drive new research into the genetic and environmental basis for human diseases of relevance to Africans as well as to build capacity for genomic research on the continent. Precision medicine requires this capacity, in addition to reference data on local populations, and skills to analyze and interpret genomic data from the bedside. The H3Africa consortium is collectively processing samples and data for over 70,000 participants across the continent, accompanied in most cases by rich clinical information on a variety of non-communicable and infectious diseases. These projects are increasingly providing novel insights into the genetic basis of diseases in indigenous populations, insights that have the potential to drive the development of new diagnostics and treatments. The consortium has also invested significant resources into establishing high-quality biorepositories in Africa, a bioinformatic network, and a strong training program that has developed skills in genomic data analysis and interpretation among bioinformaticians, wet-lab researchers, and health-care professionals. Here, we describe the current perspectives of the H3Africa consortium and how it can contribute to making precision medicine in Africa a reality.

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The content of delusions in a sample of South African Xhosa people with schizophrenia

Cited by 35 publications

References 40 publications

An evolutionary perspective on paranoia

An evolutionary perspective on paranoia

Exploring the knowledge, explanatory models of illness, and patterns of healthcare-seeking behaviour of Fang culture-bound syndromes in Equatorial Guinea

H3Africa: current perspectives

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