Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession.
Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession.
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DOI：
10.3402/ejpt.v6.29126
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发表时间：
2015
影响因子：
5
通讯作者：
van Duijl M
中科院分区：
文献类型：
--
作者：
Hecker T;Braitmayer L;van Duijl M
我们对低收入和中等收入国家（LMICs）的创伤暴露和精神占有进行了文献综述。尽管世界卫生组织在《2013-2020年精神卫生行动计划》中提出了文化上适当的精神卫生保健目标，机构间常设委员会也建议考虑当地的痛苦习惯用语并与当地资源合作，但这一主题仍然很少受到关注。病理性精神附身通常被定义为非自愿的，无法控制的，发生在仪式设置之外。它通常与污名化，痛苦和功能失调的行为有关。虽然精神占有在人类学文献中被讨论为一种痛苦的习惯用法，但最近的定量研究支持创伤经历和病理性占有状态之间的密切关系。本次审查的目的是系统地调查这种关系在中低收入国家，在辩论如何解决中低收入国家的心理健康差距。在1994年至2013年期间发表在同行评审的英语期刊上的21篇文章中，确定并分析了占有性恍惚障碍的患病率，患者的社会人口学特征及其与创伤经历的关系。对来自14个低收入国家的917名有占有性恍惚症状的患者进行的审查和分析表明，这是一种世界性的现象，具有全球相关性。这篇文献回顾表明，创伤暴露和精神占有之间存在着很强的关系，尤其是在非洲国家战后地区的高患病率。本系统性文献综述的结果表明，在人道主义紧急情况下以及中低收入国家转型期社会中，需要更多关注精神健康和心理社会干预方案中的占有性恍惚障碍。
We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review.