TY - JOUR
T1 - Psychopathology among apprentice traditional health practitioners
T2 - A quantitative study from rural KwaZulu-Natal, South Africa
AU - van der Zeijst, Martine C. E.
AU - Veling, Wim
AU - Makhathini, Elliot Mqansa
AU - Mtshemla, Sisanda
AU - Mbatha, Ndukuzakhe D.
AU - Shabalala, Sinethemba S.
AU - Susser, Ida
AU - Burns, Jonathan K.
AU - Susser, Ezra
AU - Hoek, Hans W.
PY - 2020/10/6
Y1 - 2020/10/6
N2 - Sociocultural context seems to influence the epidemiology, phenotype, treatment, and course of psychosis. However, data from low- and middle-income countries is sparse. This research is part of a multidisciplinary and multimethod study on possible mental disturbances, including hallucinations, among (apprentice) traditional health practitioners (THPs) who have experienced the "ancestral calling to become a THP" in rural KwaZulu-Natal, South Africa. The aim of the current article is to examine whether the calling-related experiences can be assessed according to a psychiatric taxonomy. We included individuals who were identified with the calling and who were undergoing training to become a THP (ukuthwasa). IsiZulu-speaking formal mental health practitioners conducted thorough psychiatric interviews that measured psychological experiences with and without distress using the Community Assessment of Psychic Experiences, and psychiatric symptoms and disorders using the Schedule for Clinical Assessment in Neuropsychiatry. Of the 48 individuals who participated, 92% had psychotic experiences (PE), causing distress in 75%; and 23% met DSM-5 criteria for an unspecified psychotic disorder (15%) or mood disorder (8%). In conclusion, in rural KwaZulu-Natal, the ancestral calling may resemble phenomena that psychiatry would understand in the context of psychosis, ranging from subclinical PE to clinical psychotic disorder. Ukuthwasa might have a beneficial influence on the course of psychotic symptoms in some individuals, potentially because it reduces stigma and promotes recovery. Further multidisciplinary research is needed to investigate the psychopathology of the apprentice THPs and the underlying processes of ukuthwasa.
AB - Sociocultural context seems to influence the epidemiology, phenotype, treatment, and course of psychosis. However, data from low- and middle-income countries is sparse. This research is part of a multidisciplinary and multimethod study on possible mental disturbances, including hallucinations, among (apprentice) traditional health practitioners (THPs) who have experienced the "ancestral calling to become a THP" in rural KwaZulu-Natal, South Africa. The aim of the current article is to examine whether the calling-related experiences can be assessed according to a psychiatric taxonomy. We included individuals who were identified with the calling and who were undergoing training to become a THP (ukuthwasa). IsiZulu-speaking formal mental health practitioners conducted thorough psychiatric interviews that measured psychological experiences with and without distress using the Community Assessment of Psychic Experiences, and psychiatric symptoms and disorders using the Schedule for Clinical Assessment in Neuropsychiatry. Of the 48 individuals who participated, 92% had psychotic experiences (PE), causing distress in 75%; and 23% met DSM-5 criteria for an unspecified psychotic disorder (15%) or mood disorder (8%). In conclusion, in rural KwaZulu-Natal, the ancestral calling may resemble phenomena that psychiatry would understand in the context of psychosis, ranging from subclinical PE to clinical psychotic disorder. Ukuthwasa might have a beneficial influence on the course of psychotic symptoms in some individuals, potentially because it reduces stigma and promotes recovery. Further multidisciplinary research is needed to investigate the psychopathology of the apprentice THPs and the underlying processes of ukuthwasa.
KW - ancestral calling
KW - (apprentice) traditional health practitioner
KW - psychopathology
KW - psychosis
KW - South Africa
KW - MENTAL-DISORDERS
KW - PSYCHIATRIC EPIDEMIOLOGY
KW - PSYCHOTIC DISORDERS
KW - RISK
KW - SCHIZOPHRENIA
KW - ILLNESS
KW - PEOPLE
KW - DISCRIMINATION
KW - EXPERIENCES
KW - HEALERS
U2 - 10.1177/1363461520949672
DO - 10.1177/1363461520949672
M3 - Article
C2 - 33021152
JO - Transcultural psychiatry
JF - Transcultural psychiatry
SN - 1363-4615
M1 - 1363461520949672
ER -