title: Role of traditional healers in the pathway to care of patients with bipolar disorder in Egypt.
abstract: BACKGROUND
  A large number of mentally ill patients prefer to visit non-medical practitioners such as traditional healers because of the confidence in the system, affordability and accessibility of the service. This may lead to delay in seeking psychiatric services and has prognostic impact.
  
  
  OBJECTIVE
  To assess the rate of bipolar affective disorder (BAD) patients seeking traditional healers, the sociodemographic and clinical correlates of those patients.
  
  
  METHODS
  We assessed 350 patients with BAD after confirmation of diagnosis with Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) research version and assessment of functioning with Global Assessment of Functioning scale. They were assessed for percent, rate and timing of seeking traditional healers.
  
  
  RESULTS
  In all, 40.8% sought traditional healers, with 34.9% more than four times. Of those, 62.2% were before seeking psychiatric services and 37.8% after. Lower educational level, less impairment of functioning and presence of hallucinations were significant correlates.
  
  
  CONCLUSIONS
  This study shows that most of the patients suffering from mental illness prefer to approach faith healers first, which may delay entry to psychiatric care and thereby negatively impact the prognosis of BAD. This highlights the importance of mental health education and developing a positive collaborative relationship with traditional healers.
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Assad
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Okasha
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Hisham
authors.initials: H
authors.lastname: Ramy
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Tamer
authors.initials: T
authors.lastname: Goueli
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Hanan
authors.initials: H
authors.lastname: El-Shinnawy
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nasr
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Heba
authors.initials: H
authors.lastname: Fathy
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: Enaba
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Ibrahim
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Elhabiby
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Nesreen
authors.initials: N
authors.lastname: Mohsen
authors.affiliation: Ain Shams University, Cairo, Egypt sherryahmed1@yahoo.com.
authors.forename: Sherien
authors.initials: S
authors.lastname: Khalil
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fekry
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Nivert
authors.initials: N
authors.lastname: Zaki
authors.affiliation: Fayoum University, Al Fayoum, Egypt.
authors.forename: Hani
authors.initials: H
authors.lastname: Hamed
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Hanan
authors.initials: H
authors.lastname: Azzam
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Marwa A
authors.initials: MA
authors.lastname: Meguid
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Menan
authors.initials: M
authors.lastname: AbdelMaksoud Rabie
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Sultan
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Soheir
authors.initials: S
authors.lastname: Elghoneimy
authors.affiliation: Cairo University, Giza, Egypt.
authors.forename: Osama
authors.initials: O
authors.lastname: Refaat
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Doaa
authors.initials: D
authors.lastname: Nader
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Doha
authors.initials: D
authors.lastname: Elserafi
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Elmissiry
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Iman
authors.initials: I
authors.lastname: Shorab
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D004522:Educational Status; D004534:Egypt; D029221:Faith Healing / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008514:Medicine, Arabic; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D055815:Young Adult
keywords: Traditional healers; bipolar patients; pathway to care