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坦桑尼亚城市地区前往初级保健诊所和传统治疗师处就诊者中的常见精神障碍

Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania.

作者信息

Ngoma Mdimu Charua, Prince Martin, Mann Anthony

机构信息

Department of Psychiatry, Muhimbili University College of Health Sciences of the University of Dar-es-Salaam, Tanzania.

出版信息

Br J Psychiatry. 2003 Oct;183:349-55. doi: 10.1192/bjp.183.4.349.

Abstract

BACKGROUND

Traditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services.

AIMS

To determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam.

METHOD

The Clinical Interview Schedule-Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 from THCs, aged 16-65 years.

RESULTS

The prevalence of common mental disorders among THC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated with THC attendance. None of these factors explained the excess of mental disorder among THC attenders.

CONCLUSIONS

The high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.

摘要

背景

传统治疗师在非洲大陆提供了一项广受欢迎且易于获得的服务。对于使用这些服务的人群的特征或心理健康状况,人们了解甚少。

目的

确定并比较达累斯萨拉姆初级卫生保健诊所(PHCs)和传统治疗师中心(THCs)就诊者中常见精神障碍的患病率及其特征。

方法

采用修订版临床访谈问卷来确定178名年龄在16 - 65岁的初级卫生保健诊所患者和176名传统治疗师中心患者中精神障碍的患病率。

结果

传统治疗师中心患者中常见精神障碍的患病率(48%)是初级卫生保健诊所患者(24%)的两倍。年龄较大、基督教徒、受教育程度较高以及离婚、分居或丧偶与前往传统治疗师中心就诊独立相关。这些因素均无法解释在传统治疗师中心就诊者中精神障碍患病率较高的现象。

结论

传统治疗师中心就诊者中精神障碍的高患病率可能反映出初级卫生保健服务未能充分检测和治疗这些常见且致残性疾病。传统治疗师应参与全面心理健康护理的规划。

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