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原住民社区的心理健康问题与传统医学的作用。

Mental health issues among indigenous communities and the role of traditional medicine.

机构信息

1 Cattolica University A. Gemelli, Rome, Italy.

2 Udayana University, Bali, Indonesia.

出版信息

Int J Soc Psychiatry. 2019 Jun;65(4):289-299. doi: 10.1177/0020764019840060. Epub 2019 Apr 12.

Abstract

INTRODUCTION

Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population.

METHODS

We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities.

RESULTS

The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs.

CONCLUSION

This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).

摘要

简介

精神卫生是世界卫生组织(WHO)关注的一个重要问题。这些社区应该生活在一个纯净、清洁和完整的环境中。但实际上,他们的处境与想象中的大相径庭。他们是弱势群体,生活在困难的地区,面临污染,远离医疗服务,易受到市场操作的影响,这些操作的目的是为了开采自然资源,此外,他们还可能受到犯罪团伙或非法土地资源开发的威胁。这些因素可能会对土著居民的心理健康产生影响。

方法

我们检索了 PubMed、EMBASE 和 The Cochrane Library 中截至 2018 年 12 月的所有可用文献,重点关注影响从传统社会向现代社会转变的因素,并回顾了与压力相关问题、影响土著/原住民社区的精神困扰以及传统医学(TM)作用相关的数据。我们还查阅了不同国家的文献,这些国家都有土著社区。

结果

土著人群中心理困扰及相关现象(如集体自杀、酗酒和暴力)的发生率受到政治和社会经济变量的影响。这些人群的精神健康状况研究和描述得都很差,尽管精神疾病的指标有些令人担忧。TM 似乎仍然在支持受影响的人群方面发挥作用,并且可以减少由于缺乏医疗保险/覆盖范围、精神病学和心理治疗而导致的不足。在医疗保健模式中结合 TM 和现代医学来满足土著人群的健康需求可能会有所帮助。

结论

本综述证实了社会变革、环境威胁和自然资源开发对土著人群精神健康的影响。全球精神卫生需要解决土著人群的健康需求,精神病学也需要开发新的类别来描述与社会差异相关的精神病理学,正如《精神障碍诊断与统计手册》(第 5 版;DSM-5)最近所提出的。

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