Popular conceptions of schizophrenia in Cape Verde, Africa.
BACKGROUND
It has been well documented that schizophrenia presents a better clinical course in developing countries. Although there are many epidemiological studies showing this association, little research has been conducted to investigate the local representation systems for schizophrenia in these countries.


OBJECTIVE
This study focuses on cultural factors of schizophrenia, namely the local representation systems for the disease, as well as what is locally understood as deviant behavior and its acceptability, and mechanisms of social-cultural insertion or exclusion of patients with schizophrenia in Cape Verde, Africa.


METHODS
Randomized open interviews were carried out with the relatives of patients under treatment at the mental health out patient service of the Batista de Sousa Hospital (São Vicente Island) between the years 1994 and 1995. Interviews dealt with patients' life histories and disease related to problems, strategies employed by the family to cope with such problems, and comments on the social and family burden.


RESULTS
20 interviews with close relatives of 10 patients were analyzed. The study focused on three main categories explaining schizophrenia: "tired head" (cabeça cansada), "nervous" (nervoso), and supernatural categories (like "sorcery" or "witchcraft"). The interviewees expressed their opinions, either explicitly or not, on whether their relatives truly had a disease.


CONCLUSIONS
Characteristics of local categories for schizophrenia found in Cape Verde can be regarded as a less stigmatized way of dealing with the disease. It is reasonable to suppose that the understanding of such cultural factors could lead to better outcomes in the treatment for schizophrenia in this country, and also in others, where similar conditions can be identified.
Mateus
Mário Dinis
MD
Universidade Federal de São Paulo, Departamento de Psiquiatria, SP, Brasil. mdmateus@ig.com.br
Santos
José Quirino dos
JQ
Mari
Jair de Jesus
Jde J
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D017028:Caregivers; D003466:Cultural Characteristics; D018864:Cultural Diversity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000175:diagnosis / Q000208:ethnology*; D012917:Social Adjustment; D013240:Stereotyping