The interrelationship of tropical disease and mental disorder: conceptual framework and literature review (part I ? malaria)

Abstract

Substantial interactions between tropical diseases and psychiatric illness have long been recognized, but the impact of biological factors in the field of cross-cultural psychiatry has been less well studied than psychosocial factors. In reviewing the literature at the intersection of tropical medicine and psychiatry in order to summarize the existing data base in this field, a generalized interactive model informed by the theoretical contributions of George Engel, the WHO Scientific Working Group on Social and Economic Research, Arthur Kleinman, P. M. Yap, Edward Sapir and others has been developed to serve as a conceptual framework for this analysis of the literature and to guide further research. The clinical literature of tropical medicine and psychiatry which recognizes the significance of concurrent tropical disease and mental disorders is reviewed along with the more specific literature on malaria and concomitant psychiatric illness. Many authors have focused on the role of organic mental disorders, especially in connection with cerebral malaria, but several have also addressed psychosocial parameters through which the interrelationship between malaria and a full range of mental disorders is also mediated. The effects of malaria may serve as biological, psychological or social stressors operating in a cultural context which precipitate or shape features of psychiatric symptomatology. Psychiatric illness may likewise precipitate an episode of malaria with typical symptoms in a patient with a previously subclinical infection. Implications of the literature and this generalized interactive model are considered as they apply to clinical practice, public health and the application of social science theory in medicine.

Positive Early Life Rainfall Shocks and Adult Mental Health

“…We use data from the 2000,2003,2006,2008, and 2011 survey rounds and merge the two data sets together to create a yearly-community level measure of disease outbreak for dengue fever and malaria. We estimate equation 2 in Table 10 and find that positive rainfall shocks increase the prevalence of both dengue and malaria, two diseases linked to depression (Barreca 2010;John et al 2015;Weiss 1985 McMichael, 2003). In the case of Indonesia, past ENSO events have been correlated with dengue epidemics (Gagnon et al, 2001).…”

“…Cerebral malaria is associated with increased risk of subsequent mental health disorder in children (John et al 2015). Among adults, malaria has been associated with concurrent mental disorders (Weiss 1985). More broadly, in utero and post-natal exposure to malaria are linked with lower adult education, income and poverty outcomes, which could be associated with adult mental health (Barreca 2010Cutler et al 2010.…”

Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine

“…With use of mefloquine at higher doses for treatment of malaria, the possible confounding of signs and symptoms of CNS toxicity by those of comorbid cerebral malaria (Weiss, 1985) creates challenges for their attribution uniquely to the drug. Similarly, with use of mefloquine at lower prophylactic doses, a lack of sensitive prospective ascertainment, particularly in resource-constrained settings, may result in neurological effects not being identified (Rønn et al, 1998).…”

Psychiatry in Africa: Special Problems and Unique Features

“…As for the bouffée delirante diagnosis, having found clinical relevance in the work of Collomb and especially in French speaking Africa, the category will probably continue to be used in Francophone Africa with little effort to integrate it within the international psychiatric mainstream. For the sake of completeness it must also be noted that some subclinical organic states have been associated with good prognosis psychoses (German, 1972;Weiss, 1985).…”