title: The content of delusions in a sample of South African Xhosa people with schizophrenia.
abstract: Although the relationship between cultural beliefs and schizophrenia has received some attention, relatively little work has emerged from African contexts. In this study we draw from a sample of South African Xhosa people with schizophrenia, exploring their cultural beliefs and explanations of illness. The purpose of the article is to examine the relationship between this cultural context and the content of delusions.
  
  
  
  A sample comprising 200 Xhosa people with schizophrenia participating in a South African schizophrenia genomics study were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Participant delusions were thematically analyzed for recurring themes.
  
  
  
  The majority of participants (n = 125 72.5%) believed that others had bewitched them in order to bring about their mental illness, because they were in some way jealous of the participant. This explanation aligns well with the understanding of jealousy-induced witchcraft in Southern African communities and highlights the important role that culture plays in their content of delusions.
  
  
  
  Improved knowledge of these explanatory frameworks highlights the potential value of culturally sensitive assessment tools and stigma interventions in patient recovery. Furthermore such qualitative analyses contribute towards discussion about aspects of delusional thought that may be more universally stable, and those that may be more culturally variable.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, 8000, South Africa. mm.campbell@uct.ac.za.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Campbell
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, 8000, South Africa.
authors.forename: Goodman
authors.initials: G
authors.lastname: Sibeko
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, 8000, South Africa.
authors.forename: Sumaya
authors.initials: S
authors.lastname: Mall
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, 8000, South Africa.
authors.forename: Adam
authors.initials: A
authors.lastname: Baldinger
authors.affiliation: Department of Psychology, Rhodes University, Grahamstown, 6140, South Africa.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nagdee
authors.affiliation: Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, USA.
authors.forename: Ezra
authors.initials: E
authors.lastname: Susser
authors.affiliation: Department of Psychiatry and Mental Health, MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, 8000, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D044383:Black People / Q000523:psychology*; D003702:Delusions / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000208:ethnology*; D012565:Schizophrenic Psychology; D013019:South Africa / Q000208:ethnology
keywords: Delusions; Illness explanations; Schizophrenia; South Africa; Xhosa people