Beruflich Dokumente
Kultur Dokumente
Ref: Kaplan & Saddock Comprehensive textbook of psychiatry 7th ed, glossary p686
Study
Prevalence of mental disorders of India- H.C.Ganguli et al (Indian Journal of Psychiatry 2000) Study of prevalence of mental disorders in India-S.Murali Madhav et al
2.
allopathic treatments. Multiple and apparently contradictory beliefs on different aspects of psychosis were often simultaneously held by participants. People in the community were more likely to express negative views about mental illness. Relatives of patients with psychosis wanted more support from mental health professionals and community in combating stigma against mental illness. The results indicate the need for better understanding of local perceptions of psychosis.
Source: Perceptions about psychosis and psychiatric services: a qualitative study from Vellore, India Saravanan .B et al.
Reason
High Prevalence Wrong perceptions Religious belief as a treatment modality Cultural practices among the people Difficulties in treating people due to religious beliefs
Objectives
To assess the perception of Psychotic illness in the
community.
tend to imagine ,orient themselves and get involved in the situation narrated to them.
To share their personal experience about the topic
1. Myths, beliefs and perceptions about mental disorders and health-seeking behavior in Delhi, India
Jugal Kishore, Avni Gupta, Ram Chander Jiloha and Patrick Bantman, Indian journal of Psychiatry
Objective :To assess the myths, beliefs and perceptions about mental disorders and health-seeking behavior in general population and medical professionals of India Methodology : Cross- Sectional study (sample of 436 subjects) Results: Major Perception: Past sins & gods punishment, Polluted air Treatment Perception: Fasting for god or a faith healer can
2.Community Beliefs About Causes and Risks for Mental Disorders:A Mental Health Literacy Survey in a Rural Area of Maharashtra, India
Michelle Kermode, Kathryn Bowen, Shoba Arole,Kaustubh Joag and Anthony F.Jorm, Indian journal of social psychiatry
Objective: To assess local knowledge and understanding of causes and risks for mental disorders in a rural area of Maharashtra and to assess the prevalence of possible common mental disorders Methodology: A qualitative study using vignettes and a quantitative cross-sectional study. Results: Most common cause - socioeconomic factors Risk group -Women, unemployed and poor people
Objective:To assess socio-cultural beliefs about the causation of mental illness and their future treatment acceptance Methodology: Qualitative research using questionnaire
Results: The commonest responses were Physical causes, sins/wrong deeds (previous life , present life.) The faith-healers are more accepted than psychiatric treatment by patients because the psychiatrist are challenging community's own beliefs.
4. Explanatory Models of Common Mental Disorders among Traditional Healers and Their Patients in Rural South India, Vellore
B. Ravi Shankar, B. Saravanan, K. S. Jacob, Indian journal of psychiatry.
Objective: To delineate concepts, categories, causes of common mental disorders (CMD) and their treatment as understood by traditional healers practicing in rural South India.
Methodology: Focus group discussions(FGD) and in-depth interviews with traditional and faith healers. It is a cross sectional study Results: Different terms, concepts and treatments were used by traditional and faith healers. Mixed anxiety depression the most common diagnosis
5. Public beliefs about and attitudes towards people with mental illness: a review of population studies
Angermeyer MC, Dietrich S, Department of Psychiatry, University of Leipzig, Leipzig, Germany
Objective :To provide a review of population-based attitude research in psychiatry during the past 15 years. Methodology : An electronic search Result : 33 national studies and 29 local and regional studies were identified, mostly from Europe. Although the majority are of descriptive nature, more recent publications include studies testing theory-based models of the stigmatization of mentally ill people, analyses of time trends and cross-cultural comparisons, and evaluations of anti stigma interventions.
Study Design: Qualitative Study Study Method: In-depth interview using a case vignette Study Period: 3 weeks from 21/01/2013 -09/02/2013
MAP
Qualitative :
We compiled all transcript into a master transcript Multiple reading of transcript was done Text was decontextualised and deductive codes were made Manual content analysis was done and themes were generated
Table no.1: Perception of psychotic illness among the study participants (N= 189) Q:What do you feel about this condition?
Category Sounds to be dangerous (n=186) Response Yes No Appears to be curable (n=187) Effects of wrong deeds (n=186) Yes No Yes No Happens only to bad persons (n=186) Yes No Number 135 51 172 15 81 105 19 167 % 72.6 27.4 92.0 8.0 43.5 56.5 10.2 89.8
Table no.2: Perceived Cause of the psychotic illness (N = 189) Q: What do you think could have caused this?
S.No Cause Number %
1.
2. 3.
Accidental injury
Brain disturbance Addictions
61
86 37
32.3
45.5 19.6
4.
5. 6. 7.
Disturbances in family
Stress/tension at work Genetic/familial Others *
122
101 30 76
64.6
53.4 15.9 40.2
* Others included fear, seeing shocking incidents, bad deeds done by the parents and ancestors etc. # Includes multiple responses: Do not add to 100%
Books &stories
Love failures
Depression
Negative thoughts
Mental disturbance
Marital disharmony
Chart 2: Societal attitude towards people with psychotic illness (N= 188)
Q: How do you feel about the societal attitude towards this problem?
POSITIVE
30.4% (57)
34% (64)
NEGATIVE
NEUTRAL
35.6% (67)
Table 3: Community opinion about violence/abuse towards people with psychosis (N= 186)
Q: Do you feel that people suffering from such illness are subjected to abuse/violence from the society?
S.No
Response
Frequency
1. 2. 3.
122 19 45
65.6 10.2
24.2
Community Perception about hidden identity of the people with psychosis (N= 187) Majority (71%) agreed to the above response and the possible reasons were as follows, 9%
Stigma
47% 44%
Isolation Others
Others: To avoid problems during marriage, for family respect, fear of society etc.
Perception of study participants about the treatment of psychotic illness (N=189) Response: Yes it can be treated (majority, 99%) Table 4: Perception of study participants about the place of treatment of psychotic illness
S. No
1 2 3 4
Response
At home Faith Healers Hospitals(doctors) Others
Frequency
18 55 157 20
%
9.5 29.1 83.1 10.6
Q: Can you recall similar incident in your life( either own family members or outsiders)? N = 185
56 54 52 50 48 46 44 42 40
54.1%
Yes No
45.9%
Horror stories and program Movies Childhood fairy tales and horror stories.
External influences
Scientific
Hormonal imbalance Neuronal problems Brain damage
Support Education
Love Care
Positive
Sympathy Treatment Societal attitude towards persons with psychotic illness Negligence Criticism Isolation Abuse Violence
Negative
Burden
Psychotic illness
Gender preferences Males Females
Suicide prone For future Torture by faith healers Violence Emotional instability Superstitions
Not concealed
SELF IDENTITY
Concealed
stigma
Rural area
Family support
isolation
prestige
Allopathic Rx
Electric shock
Neurologist
Psychiatrist
Alternative medicine
Faith healers Neem leaves Chaining them torture Sacrificing animals to evil spirits Pooja on new moon day Temple Mosque Holy thread
The haunting
Pratibha: 21 yrs lives with her family Possessed by an evil spirit 4 months ago when walking alone at midnight. Strange behavior- change in voice-crying- refused to take food- hit herself to wall. Family members- worried took her to Mel Malayanur temple Pratibha ill treated- beaten with brooms- neem leaves- tongue pierced- ash blown on face, etc.
I have seen similar incident when I was in cuddalore. A girl of 15yrs of age who was my neighbour lived with her father, mother and grandma. Her grandma was not well for some days then she died one day.
After that the girl tend to behave abnormally she used to run on the road, used to speak meaningless words, not interested in eating and dressing. This continued to happen for 1 month . Parents didnt bring the girl to hospital
Faith healer told that the girl was possesed by the soul of her grandma because she had seen the last breath of her grandma. Then the faith healer did one pooja and tied one Thayathu over the girls hand . After that girl recovered gradually over a period of time then family shifted their house to chennai due to fear of evil spirit.
Narration 3
SNAKE BITE STORY
Superstitious belief
A boy loved a girl since childhood. He was bitten by a snake and died-10 years. Girl attained puberty, aftr that stared behaving strange. Soul of the dead boy entered the girl's body. Complains of fear and pain. Faith healers. Hospital. 90 percent cured.
Narration 4
The respondent shared a similar incident, which happened in his friends life. His friend had a great belief in horoscope . His friend believed that the day in which a person takes birth decides the happiness or sadness of his or her life. He thought that he was not born on an auspicious day and thats a reason for his sorrows and sufferings. There is a voice in him which says him to commit suicide on a
Particular day so that his soul will take a rebirth on an auspicious day and his life will be filled with happiness and joy. So he has tried to commit suicide many times but he was saved by his family members . Finally he went to some other city and stayed there in a lodge and commit suicide.
Conclusion
91% of the participants felt that the condition is
curable.( n=187 ) 35.4% of the participants feel that social status might affect this condition. According to 35.6% of the participants, societal attitude is negative towards this condition.(n=188) 98.9% feel that this condition needs to be treated and 83.1% feel that this condition should be treated at hospital while 29.1% feel that it should be treated by faith healers.(n=189)
Conclusion
To build up rapport with people
them sit) The methods of putting questions to get the best response The art of probing The various cultural beliefs in the minds of people We realized the importance of patience