The prevalence and severity of mental illnesses handled by traditional healers in two districts in Uganda.
BACKGROUND
Little is known about the prevalence and severity of DSM-IV mental disorders treated by traditional healers in Uganda.


OBJECTIVE
To describe the prevalence and severity of DSM-IV disorders handled by traditional healers in Jinja and Iganga districts, Eastern Uganda.


METHODS
Between January and March 2008, Face-to-Face Interviews were conducted with 400 patients attending traditional healers' shrines for mental health problems, using Self Rating Questionnaire 25 (SRQ-25) for screening, the Mini International Neuropsychiatric Interview (MINI-Plus) for specific DSM-IV diagnosis and the Global Assessment of Functioning (GAF) for severity of illness. Descriptive data analysis and frequency estimates were performed using SPSS version 15.0 for Windows. Pearson's chi-square tests and odds ratios were used to explore the relationship between severity and combined use of biomedical services and traditional healing.


RESULTS
Of 387 respondents, 60.2% had diagnosable current mental illness and 16.3% had had one disorder in their lifetime. Of the diagnosable current mental illnesses, 29.7% were Psychosis; 5.4% Major depressive episode; 5.6% Anxiety disorders; 3.6% mixed Anxiety-Depression; and 3.9% Suicidality. In terms of severity, 37.7% of the current mental illnesses were severe, 35.1% moderate and 13.2% mild. Patients with moderate to severe symptoms were more likely to use both biomedical services and traditional healers.


CONCLUSIONS
These findings suggest that a considerable number of patients with DSM-IV diagnosable mental disorders attend traditional healing shrines; the majority had moderate to severe symptoms. Mental health professionals therefore need to come up with ways to co-operate with traditional healers, e.g. as officially designated Traditional Mental Attendants (TMA), for the benefit of their patients.
Abbo
Catherine
C
Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institutet, Stockholm, Sweden. Catherine.Abbo@ki.se
Ekblad
Solvig
S
Waako
Paul
P
Okello
Elialilia
E
Musisi
Seggane
S
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D016488:Medicine, African Traditional; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D015588:Observer Variation; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult