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01.12.2012 | Research | Ausgabe 1/2012 Open Access

International Journal of Mental Health Systems 1/2012

Naturalistic outcome of treatment of psychosis by traditional healers in Jinja and Iganga districts, Eastern Uganda – a 3- and 6 months follow up

Zeitschrift:
International Journal of Mental Health Systems > Ausgabe 1/2012
Autoren:
Catherine Abbo, Elialilia S Okello, Seggane Musisi, Paul Waako, Solvig Ekblad
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-4458-6-13) contains supplementary material, which is available to authorized users.

Competing interest

The Authors declare that they have no competing interests.

Authors’ contribution

At the time of the study, the first author, CA was a PhD student being supervised by SE, ESO, PW and SM. CA supervised data collection, participated in data analysis and drafted the manuscript. All authors participated in the study from its inception, read through and approved manuscript.

Abstract

Objective

To determine the naturalistic outcome of treatment of psychosis by traditional healers in Jinja and Iganga districts of Eastern Uganda.

Method

A cohort of patients with psychosis receiving treatment from traditional healers’ shrines were recruited between January and March 2008 and followed up at three and six months. The Mini International Neuropsychiatry Interview (MINI Plus) was used for making specific diagnosis at the point of contact. For specific symptoms, Positive and Negative Symptom Scale (PANSS), Young Mania Rating Scale (YMRS) and Montgomery Asberg Depression Rating Scale (MADRS) were used to measure severity of schizophrenia, mania and psychotic depression, respectively. The Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) were used for objective assessments. The Compass Mental Health Index measured well being. Mean scores of the scales were computed using one way ANOVA for independent samples. Associations between outcome and categorical variables were examined at bivariate and multivariate levels.

Results

All the symptom scales had a percentage reduction of more than 20% at three and six months follow up. The differences between the mean scores of the scales at baseline and 3 months, baseline and 6 months, and 3 and 6 months were all significant (P < 0.0001). The post test for pair wise comparisons, the Tukey HSD (Honestly Significant Difference) test was also all significant at P < 0.01 except for MADRS where there was no significant difference between 3 and 6 months for depression severity. Over 80% of the participants used biomedical services for the same symptoms in the study period. At 3 months follow up, patients who combined treatment were less likely to be cases (P = 0.002; OR 0.26 [0.15-0.58]), but more likely to be cases at 6 months follow up (P = 0.020; OR 2.05 [1.10-3.189]). Being in debt was associated with caseness both at 3 and 6 months.

Conclusion

This study suggests that there may be some positive effects for patients with psychosis who combine both biomedical services and traditional healing. Further research in the area of naturalistic outcome of traditional healing is necessary.
Zusatzmaterial
Authors’ original file for figure 1
13033_2012_136_MOESM1_ESM.pdf
Authors’ original file for figure 2
13033_2012_136_MOESM2_ESM.pdf
Authors’ original file for figure 3
13033_2012_136_MOESM3_ESM.doc
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