Ayehu Moges, Endriyas Misganu, Mekonnen Emebet, Shiferaw Mekonen, Misganaw Tebeje
1College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
2SNNPR Health Bureau, Hawassa, Ethiopia.
Int J Ment Health Syst. 2018 Jun 7;12:31. doi: 10.1186/s13033-018-0207-1. eCollection 2018.
Outbreaks of mass psychogenic illness (MPI), which are a constellation of physical signs and symptoms suggestive of organic illness with no identifiable causes. MPI has been documented in numerous cultural, ethnic, and religious groups throughout the world. The aims of this study were to document the nature and impacts of the illness, to assess interventions, and to come up with recommendations and management formulations for dealing with such kinds of outbreaks in the future.
Community based cross-sectional study was conducted in June, 2015 in Derashe Woreda, Segen Area People Zone of the Southern Nations Nationalities and People's Region. Women with complaints of breast cancer but with no objective findings were the subjects of the study. Ninety-seven women were investigated using a semi-structured questionnaire for quantitative study. Two focus group discussions with seven affected and seven non-affected women and four key informant interviews were conducted using guiding questionnaires. Quantitative data was analyzed using SPSS version 20 software packages while qualitative data was analyzed manually going through thematic areas.
The ages of the ninety-seven study participants ranged from 17 to 56 years, with a mean (SD) of 32.8 (8.7) years. Onset of illness was dated back to the year 2012 following the death of a 43 year old socially active woman with complications of breast cancer. Following her death many women started to report multiple vague physical complaints similar to those of the deceased woman. Even though the responses from the study participants did not specifically point to a single possible cause and means of transmission, high numbers of women believed the source of their illness could be punishment from God while some said that the cause of their suffering could be environmental pollution. Since the illness was taken to be contagious, affected women faced stigma and discrimination. Moreover, school activities and social gatherings were limited significantly.
Unrealistic and exaggerated rumors and inadequate explanations about the nature and spread of the illness were the main contributing factors for the spread and prolongation of the outbreak. An organized intervention, clear and adequate explanations about the nature and transmission of the illness can contain MPI within a short period of time.
群体性心因性疾病(MPI)暴发是一组提示存在器质性疾病但无明确病因的体征和症状。MPI在世界各地众多文化、种族和宗教群体中均有记载。本研究的目的是记录该疾病的性质和影响,评估干预措施,并提出未来应对此类暴发的建议和管理方案。
2015年6月在南方各族州塞根地区人民区德拉萨赫乡开展了一项基于社区的横断面研究。以主诉患有乳腺癌但无客观检查结果的女性为研究对象。采用半结构化问卷对97名女性进行定量研究调查。使用指导性问卷对7名患病女性和7名未患病女性进行了两次焦点小组讨论,并进行了4次关键 informant访谈。定量数据使用SPSS 20版软件包进行分析,而定性数据则通过主题领域进行人工分析。
97名研究参与者的年龄在17至56岁之间,平均(标准差)为32.8(8.7)岁。疾病暴发始于2012年,一名43岁患有乳腺癌并发症的社会活跃女性去世之后。她去世后,许多女性开始报告出现与已故女性相似的多种模糊身体不适症状。尽管研究参与者的回答未明确指出单一可能病因和传播途径,但大量女性认为疾病根源可能是上帝的惩罚,也有人表示患病原因可能是环境污染。由于该疾病被认为具有传染性,患病女性面临耻辱和歧视。此外,学校活动和社交聚会也受到显著限制。
对疾病性质和传播的不切实际且夸大的谣言以及解释不足是疫情传播和持续时间延长的主要促成因素。有组织的干预措施、对疾病性质和传播的清晰充分解释能够在短时间内控制群体性心因性疾病暴发。