A Culture-Bound Syndrome ‘Amafufunyana’ and a Culture-Specific Event ‘Ukuthwasa’: Differentiated by a Family History of Schizophrenia and other Psychiatric Disorders
| Autor: | Piet Oosthuizen, Esme Jordaan, Robin Emsley, Jean-Francois Deleuze, Dan J. Stein, Mbanga Ni, Claudine Laurent, Dana J.H. Niehaus, Christine Lochner, N. Keyter |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Nosology Psychosis medicine.medical_specialty Curandero medicine Humans Genetic Predisposition to Disease Family history Psychiatry Cultural Characteristics Family story Social environment Syndrome Culture-bound syndrome Middle Aged Prognosis medicine.disease language.human_language Diagnostic and Statistical Manual of Mental Disorders Psychiatry and Mental health Clinical Psychology Schizophrenia language Female Schizophrenic Psychology Medicine Traditional Xhosa Psychology |
| Zdroj: | Psychopathology. 37:59-63 |
| ISSN: | 1423-033X 0254-4962 |
| Popis: | Background: ‘Amafufunyana’ and ‘ukuthwasa’ are two culture-specific descriptive terms used by Xhosa traditional healers to explain aberrant behavioral and psychological phenomena. Some overlap between these conditions and schizophrenia (DSM-IV) is apparent. The aim of this study was to determine the extent to which amafufunyana and ukuthwasa were used as cultural explanatory models by traditional healers for DSM-IV-defined schizophrenia and whether there were significant phenomenological differences in schizophrenia symptoms in patients with the diagnosis of amafufunyana rather than ukuthwasa. Sampling and Methods: Xhosa patients with schizophrenia underwent a structured clinical diagnostic interview (Diagnostic Interview for Genetic Studies). The use of traditional diagnostic and treatment methods was assessed by structured open-ended interviewer-rated questions. The sample was then stratified for the presence/absence of a past/current diagnosis of amafufunyana and/or ukuthwasa. The clinical parameters were compared across groups by means of the χ2 or Student t tests. Results: 247 adult subjects participated in the study. 106 (53%) patients reported a previous diagnosis of amafufunyana, and 9 (4.5%) reported a diagnosis of ukuthwasa. A family history of schizophrenia (p = 0.004) or any psychiatric disorder (p = 0.008) was more common in the ukuthwasa group. Subjects with a primary diagnosis other than amafufunyana or ukuthwasa were more likely to be married (p = 0.004), to have a history of stressor(s) prior to illness onset (p = 0.026), to be from a rural environment (p = 0.007) or to have a history of cannabis abuse/dependency (p = 0.015). Conclusion: The culture-bound syndrome amafufunyana and the culture-specific phenomenon of ukuthwasa are both used to explain symptoms in patients with schizophrenia (DSM-IV). Identification of cases as amafufunyana and ukuthwasa may correlate with a distinction between familial and sporadic cases of schizophrenia. Whether the positive connotations associated with ukuthwasa, as opposed to the more negative connotations associated with amafufunyana, hold any implications for the treatment or prognosis of schizophrenia remains to be clarified. |
| Databáze: | OpenAIRE |
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