Üçok Alp, Tekin Atilla, Göçüm Erkan, Aydın Sena, Sarıbaş Ekin Deniz, Arslan Mehmet Alper, Ince-Guliyev Ezgi, Direk Tecirli Neşe
Department of Psychiatry, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Department of Psychiatry, Adıyaman University Faculty of Medicine, Adıyaman, Turkey.
Int J Soc Psychiatry. 2025 Feb;71(1):129-137. doi: 10.1177/00207640241284242. Epub 2024 Oct 10.
Help-seeking from traditional healers (TH) is common in patients with severe mental illness. However, the differences between patients with schizophrenia and bipolar disorder are not well-known. Although internalized stigma is also common in patients with severe mental illness, its impact on help-seeking from TH is not studied.
To investigate help-seeking from TH and the relationship between help-seeking from TH and internalized stigma in patients with schizophrenia and bipolar disorder.
In this cross-sectional study, we collected information about help-seeking from TH and clinical characteristics by using a semi-structured interview form from 310 patients with schizophrenia and bipolar disorder in two sites with different socio-cultural backgrounds. We measured internalized stigma by using The Internalized Stigma of Mental Illness (ISMI) scale.
We found that 47% of the patients visited TH in any phase of their illness, and 46% of them sought help from TH before their first contact with a psychiatrist. Those who grew up in rural areas, were less educated, who attempted suicide before, with resistance to treatment, and with a family member who also admitted to TH were more frequent among the help-seekers from TH. This group also had more hospitalizations and higher Clinical Global Impression scores. Internalized stigma was found to be higher in the schizophrenia group, and it was related to help-seeking from TH and delay in admission to psychiatric facilities.
Our findings suggest that help-seeking from TH is common both in patients with schizophrenia and bipolar disorder, and it has socio-cultural, illness-related, and stigma-related predictors.
在患有严重精神疾病的患者中，向传统治疗师（TH）寻求帮助的情况很常见。然而，精神分裂症患者和双相情感障碍患者之间的差异尚不为人所知。尽管内化耻辱感在患有严重精神疾病的患者中也很常见，但尚未研究其对向传统治疗师寻求帮助的影响。
调查精神分裂症和双相情感障碍患者向传统治疗师寻求帮助的情况，以及向传统治疗师寻求帮助与内化耻辱感之间的关系。
在这项横断面研究中，我们通过半结构化访谈表格，收集了来自两个具有不同社会文化背景地点的310名精神分裂症和双相情感障碍患者向传统治疗师寻求帮助的信息以及临床特征。我们使用精神疾病内化耻辱感（ISMI）量表来测量内化耻辱感。
我们发现，47%的患者在疾病的任何阶段都拜访过传统治疗师，其中46%的患者在首次接触精神科医生之前就向传统治疗师寻求过帮助。在向传统治疗师寻求帮助的患者中，那些在农村地区长大、受教育程度较低、之前有过自杀企图、抗拒治疗以及有家庭成员也向传统治疗师求助的患者更为常见。这组患者的住院次数也更多，临床总体印象评分更高。研究发现，精神分裂症组的内化耻辱感更高，且与向传统治疗师寻求帮助以及延迟入住精神科机构有关。
我们的研究结果表明，精神分裂症和双相情感障碍患者向传统治疗师寻求帮助的情况都很常见，并且有社会文化、疾病相关和耻辱感相关的预测因素。
