Musisi Seggane, Kinyanda Eugene
Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
College of Health Sciences, Makerere University, Kampala, Uganda.
Front Psychiatry. 2020 Feb 25;11:20. doi: 10.3389/fpsyt.2020.00020. eCollection 2020.
This chapter describes how chronic conflict, warfare, and persecution, as lived experiences, have created significant mental distress in communities on the African continent. There is a growing body of research that highlights increasing mental distress in Africa e.g., about sexuality, health, disease, modernity, climate, politics, culture, religion, ethnicities, race, economies etc. Many of these stresses and uncertainties are driven by political persecution, war, and conflict. This has shaped many African people's attitudes and government policies and an increasing scholarly interest in exploring these "uncertainties and mental distresses in Africa." The chapter will show how trauma, as seen in conflict/post-conflict settings in Africa, causes significant mental stress and associated social problems as well as medically-defined PTSD syndromes, anxiety, and depression which cause much morbidity and retard development in many African communities. Taking a classical look at post-traumatic stress disorder, PTSD, the chapter explores the presentation of the various physical and mental clinical syndromes related to war-trauma on the African continent and the consequent health-seeking behaviors of the African peoples in this regard. The term "culture-bound PTSD syndromes" will be introduced and discussed in the broader context of treatment, rehabilitation, and prevention on the continent and worldwide. It will also discuss the dilemma of the vicious cycles of trauma driven by appetitive aggression in today's Africa which portends to further retard socio-economic development and drives the trans-generational perpetuation of ethnic-based conflicts including genocides. Despite this mass traumatization, the chapter points to the virtual absence of post-conflict mental health policies in almost all African countries, hence leading to discussions of "best-practices" recommendations.
本章描述了长期冲突、战争和迫害作为生活经历，如何在非洲大陆的社区中造成了严重的精神痛苦。越来越多的研究强调了非洲精神痛苦的增加，例如关于性取向、健康、疾病、现代性、气候、政治、文化、宗教、种族、经济等方面。这些压力和不确定性中的许多是由政治迫害、战争和冲突驱动的。这塑造了许多非洲人的态度和政府政策，也引发了学术界对探索这些“非洲的不确定性和精神痛苦”日益浓厚的兴趣。本章将展示在非洲冲突/冲突后环境中出现的创伤如何导致严重的精神压力和相关的社会问题，以及医学上定义的创伤后应激障碍综合征、焦虑和抑郁，这些在许多非洲社区中造成了很高的发病率并阻碍了发展。本章以经典视角审视创伤后应激障碍（PTSD），探讨非洲大陆与战争创伤相关的各种身心临床综合征的表现，以及非洲人民在这方面相应的求医行为。“文化束缚型PTSD综合征”这一术语将在该大陆及全球范围内治疗、康复和预防的更广泛背景下被引入并讨论。本章还将讨论当今非洲由欲望性攻击驱动的创伤恶性循环所带来的困境，这种困境预示着将进一步阻碍社会经济发展，并导致基于种族的冲突（包括种族灭绝）跨代延续。尽管存在这种大规模创伤，但本章指出几乎所有非洲国家都几乎没有冲突后心理健康政策，因此引发了关于“最佳实践”建议的讨论。
