Department of Psychiatry and Psychotherapy, Charité - Berlin, Germany.
Eur Psychiatry. 2012 Jun;27 Suppl 2:S44-9. doi: 10.1016/S0924-9338(12)75707-3.
Subjective explanations of illness concepts and disease can differ from culture to culture. We examined explanatory models of West African patients with schizophrenia in a community-centred department of psychiatry in Mali, West Africa.
Patients and experts volunteered to be interviewed in the Department of Psychiatry of the University Hospital, Pont G, in Bamako, the capital of Mali. We used semi-structured interviews to explore key psychotic symptoms and explanatory models of psychosis in five experts and fifteen patients with schizophrenia. All interviews were analysed using computer assisted content-analysis with the program Atlas.ti.
African patients displayed key symptoms of schizophrenia such as commenting and imperative voices, inserted thoughts and other phenomena of alien control, which were often subjectively explained as obsession by witches or jinns. Explanatory models differed depending on occidental migration experience and age. The involvement of family members in the treatment-setting facilitates inclusion and recovery. Experts emphasized the need to integrate traditional and ethno-pharmacological approaches and modern medicine to treat their patients in a culture sensitive manner.
Our data suggests a strong influence of illness concepts on the experience of psychotic symptoms, treatment expectations and health-related behaviour.
疾病的主观解释在不同文化中可能存在差异。我们在马里一个以社区为中心的精神病学部门研究了西非精神分裂症患者的解释模型。
患者和专家自愿在马里首都巴马科的 Pont G 大学医院的精神病学系接受采访。我们使用半结构化访谈来探索五位专家和十五位精神分裂症患者的主要精神病症状和精神病解释模型。所有访谈均使用计算机辅助内容分析程序 Atlas.ti 进行分析。
非洲患者表现出精神分裂症的主要症状，如评论性和命令性声音、插入性思维和其他被外来控制的现象，这些症状通常被主观地解释为女巫或精灵的附身。解释模型取决于西方移民经历和年龄。家庭成员参与治疗环境有助于包容和康复。专家强调需要整合传统和民族药理学方法以及现代医学，以文化敏感的方式治疗他们的患者。
我们的数据表明，疾病观念对精神病症状的体验、治疗期望和与健康相关的行为有很大的影响。
