Exploring the apparent absence of psychosis amongst the Borana pastoralist community of Southern Ethiopia. A mixed method follow‐up study
Exploring the apparent absence of psychosis amongst the Borana pastoralist community of Southern Ethiopia. A mixed method follow‐up study
复制标题
探索埃塞俄比亚南部博拉纳牧民社区明显不存在精神病的混合方法随访研究。
作者：
T. Shibre;Solomon Teferra;C. Morgan;A. Alem
很少有关于孤立人群中精神障碍患病率的报道。如果存在的话，流行率估计值的变化引起了对这种情况下病例确定方法的有效性的质疑。在以前使用复合国际诊断访谈对埃塞俄比亚Borana牧民社区进行的基于人口的调查中，没有发现精神分裂症病例。为了进一步探索这一发现并调查严重精神障碍是如何概念化的，我们与Borana牧民社区的主要成员进行了焦点小组讨论。随后，焦点小组的参与者被用作关键的线人，以确定可能的精神障碍的情况下，根据他们的概念。由一名受过训练的精神病医生使用神经精神病学临床评估计划表（SCAN）对关键举报人确定的病例进行访谈，以确认是否存在疾病。重点小组的讨论要经过专题分析。地方概念和精神病学概念之间的不一致主要在于，关键的被调查者描述marata（“疯狂”）的特征是明显的行为症状。在焦点小组讨论之后，参与者确定了8名精神分裂症患者和13名精神病性情绪障碍患者，并通过SCAN访谈进行了确认。在这样的社区精神障碍的研究可能会受益于结构化访谈与关键线人的方法相结合。
There are few reports of the prevalence of psychotic disorders among isolated population groups. Where present, variations in prevalence estimates raise questions about the validity of methods of case ascertainment in such settings. In a previous population-based survey of the Borana pastoralist community in Ethiopia using the Composite International Diagnostic Interview, no cases of schizophrenia were identified. In order to further explore this finding and investigate how serious mental disorder is conceptualized, we conducted focus group discussions with key members of the Borana pastoralist community. Subsequently, focus group participants were used as key informants to identify cases with possible psychotic disorder, based on their conceptualization. Cases identified by key informants were interviewed by a trained psychiatrist using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), to confirm presence of disorder. Focus group discussions were subjected to thematic analysis. The incongruity between local and psychiatric concepts lay mainly in the fact that key informants described characteristics of marata ("madness") in terms of overt behavioural symptoms. Following the focus group discussions, participants identified eight individuals with schizophrenia and 13 with a psychotic mood disorder, confirmed through SCAN interview. Studies of psychotic disorders in such communities are likely to benefit from combining structured interviews with the key informant method.