Parnassia Psychiatric Institute, The Hague, The Netherlands.
University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Transcult Psychiatry. 2021 Aug;58(4):486-498. doi: 10.1177/1363461520949672. Epub 2020 Oct 6.
Sociocultural context seems to influence the epidemiology, phenotype, treatment, and course of psychosis. However, data from low- and middle-income countries is sparse. This research is part of a multidisciplinary and multimethod study on possible mental disturbances, including hallucinations, among (apprentice) traditional health practitioners (THPs) who have experienced the "ancestral calling to become a THP" in rural KwaZulu-Natal, South Africa. The aim of the current article is to examine whether the calling-related experiences can be assessed according to a psychiatric taxonomy. We included individuals who were identified with the calling and who were undergoing training to become a THP (). IsiZulu-speaking formal mental health practitioners conducted thorough psychiatric interviews that measured psychological experiences with and without distress using the Community Assessment of Psychic Experiences, and psychiatric symptoms and disorders using the Schedule for Clinical Assessment in Neuropsychiatry. Of the 48 individuals who participated, 92% had psychotic experiences (PE), causing distress in 75%; and 23% met DSM-5 criteria for an unspecified psychotic disorder (15%) or mood disorder (8%). In conclusion, in rural KwaZulu-Natal, the ancestral calling may resemble phenomena that psychiatry would understand in the context of psychosis, ranging from subclinical PE to clinical psychotic disorder. might have a beneficial influence on the course of psychotic symptoms in some individuals, potentially because it reduces stigma and promotes recovery. Further multidisciplinary research is needed to investigate the psychopathology of the apprentice THPs and the underlying processes of .
社会文化背景似乎会影响精神病的流行病学、表现、治疗和病程。然而，来自中低收入国家的数据却很匮乏。本研究是对南非夸祖鲁-纳塔尔省农村地区（准）传统医疗从业者（THP）可能存在的精神障碍（包括幻觉）进行的多学科、多方法研究的一部分，这些从业者经历了“祖传的召唤成为 THP”。本文的目的是检验根据精神病学分类法是否可以评估与召唤相关的经历。我们纳入了那些被认定具有召唤并正在接受培训成为 THP 的人（）。讲祖鲁语的正式精神卫生从业者进行了彻底的精神病学访谈，使用社区心理体验评估量表测量了有和没有痛苦的心理体验，并使用神经精神病学临床评估量表测量了精神症状和障碍。在 48 名参与者中，92%的人有精神病性体验（PE），其中 75%的人感到痛苦；23%的人符合 DSM-5 未特指的精神病性障碍（15%）或心境障碍（8%）的标准。总之，在夸祖鲁-纳塔尔省农村地区，祖传的召唤可能类似于精神病学在精神病背景下理解的现象，范围从亚临床 PE 到临床精神病性障碍。召唤可能对一些人的精神病症状的病程产生有益的影响，这可能是因为它减少了耻辱感并促进了康复。需要进一步进行多学科研究，以调查学徒 THP 的精神病理学以及召唤的潜在过程。
