Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Int J Soc Psychiatry. 2011 Sep;57(5):538-45. doi: 10.1177/0020764010390199. Epub 2010 Nov 15.
Causal belief systems and help-seeking practices may impact on pathway to care and features of first-episode psychosis (FEP) that have prognostic value. This is particularly relevant in South Africa where many people subscribe to traditional belief systems and consult traditional healers.
To evaluate the relationship between causal attributions and pathway to care and features of FEP that have prognostic value.
We tested associations between causal attributions and pathway to care and duration of untreated psychosis (DUP), age of onset, PANSS-rated positive, negative and general symptoms and depressive symptoms (Calgary Depression Scale) in a sample of 54 FEP patients.
Spiritual attribution of cause (49% of patients) was associated with long DUP, while consultation with a traditional healer (39% of patients) was associated with long DUP and high negative symptoms. Only 19% had consulted a psychiatrist. Seventy nine per cent (79%) were referred to hospital by family, police were involved in 44% of admissions, and 81% were admitted involuntarily.
Spiritual attributions of cause and previous consultation with traditional healers may delay entry to psychiatric care and thereby negatively impact on prognosis of FEP. This highlights the importance of mental health education and developing a positive collaborative relationship with traditional healers, especially in low- and middle-income countries.
因果信念系统和求助行为可能会影响到精神病患者的治疗途径和具有预后价值的首发精神病（FEP）特征。在南非，这一点尤为重要，因为许多人信奉传统信仰体系，并会寻求传统治疗师的帮助。
评估因果归因与具有预后价值的精神病患者的治疗途径和特征之间的关系。
我们在 54 名首发精神病患者的样本中测试了因果归因与治疗途径和未治疗精神病持续时间（DUP）、发病年龄、阳性症状、阴性症状和一般症状（阳性和阴性症状量表）和抑郁症状（卡尔加里抑郁量表）之间的关联。
精神归因（49%的患者）与较长的 DUP 相关，而与传统治疗师的咨询（39%的患者）与较长的 DUP 和较高的阴性症状相关。只有 19%的患者咨询过精神科医生。79%的患者由家人转介到医院，44%的入院是由警察介入的，81%的患者是被强制入院的。
精神归因和以前向传统治疗师咨询可能会延迟精神病患者进入精神科治疗，从而对首发精神病的预后产生负面影响。这突出了心理健康教育的重要性，以及与传统治疗师建立积极的合作关系的重要性，特别是在中低收入国家。
