Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

The content of delusions in a sample of South African Xhosa people with schizophrenia

Authors: Megan M. Campbell, Goodman Sibeko, Sumaya Mall, Adam Baldinger, Mohamed Nagdee, Ezra Susser, Dan J. Stein

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.
Literature
1.
Sartorius N, Shapiro R, Jablensky A. The international pilot study of schizophrenia. Schizophr Bull. 1974;1(11):21.CrossRef
2.
Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A. Schizophrenia: manifestations, incidence and course in different cultures A World Health Organization Ten-Country Study. Psychol Med Monogr Suppl. 1992;20:1–97.CrossRefPubMed
3.
Gold J, Gold I. The “Truman Show” delusion: psychosis in the global village. Cogn Neuropsychiatry. 2012;17(6):455–72.CrossRefPubMed
4.
Stompe T, Ortwein-Swoboda G, Ritter K, Schanda H. Old wine in new bottles? Psychopathology. 2003;36(1):6–12.CrossRefPubMed
5.
Kalra G, Bhugra D, Shah N. Cultural aspects of schizophrenia. Int Rev Psychiatry. 2012;24(5):441–9.CrossRefPubMed
6.
Stompe T, Friedman A, Ortwein G, Strobl R, Chaudhry H, Najam N, et al. Comparison of delusions among schizophrenics in Austria and in Pakistan. Psychopathology. 1999;32(5):225–34.CrossRefPubMed
7.
Kim K-I, Li D, Jiang Z, Cui XJ, Lin L, Kang JJ, et al. Schizophrenic delusions among Koreans, Korean-Chinese and Chinese: A transcultural study. Int J Soc Psychiatry. 1993;39(3):190–9.CrossRefPubMed
8.
9.
Rudalevičienė P, Adomaitienė V, Stompe T, Narbekovas A, Meilius K, Raškauskienė N, et al. Delusions of persecution and poisoning in patients with schizophrenia: sociocultural and religious background. Med (Lithuania). 2010;46(3):185–92.
10.
Suhail K. Phenomenology of delusions in Pakistani patients: Effect of gender and social class. Psychopathology. 2003;36(4):195–9.CrossRefPubMed
11.
Gecici O, Kuloglu M, Guler O, Ozbulut O, Kurt E, Onen S, et al. Phenomenology of delusions and hallucinations in patients with schizophrenia. Klin Psikofarmakol B. 2010;20(3):204–12.
12.
Cannon BJ, Kramer LM. Delusion content across the 20th century in an American psychiatric hospital. Int J Soc Psychiatry. 2012;58(3):323–7.CrossRefPubMed
13.
Bhavsar V, Bhugra D. Religious delusions: finding meanings in psychosis. Psychopathology. 2008;41(3):165–72.CrossRefPubMed
14.
Stompe T, Bauer S, Ortwein-Swoboda G, Schanda H, Karakula H, Rudalevicienne P, et al. Delusions of guilt: The attitude of Christian and Muslim schizophrenic patients toward good and evil and the responsibility of men. J Muslim Ment Health. 2006;1(1):43–56.CrossRef
15.
Tateyama M, Asai M, Hashimoto M, Bartels M, Kasper S. Transcultural study of schizophrenic delusions. Psychopathology. 1998;31(2):59–68.CrossRefPubMed
16.
Suhail K, Cochrane R. Effect of culture and environment on the phenomenology of delusions and hallucinations. Int J Soc Psychiatry. 2002;48(2):126–38.CrossRefPubMed
17.
Connell A, Koen L, Niehaus D, Cloete KJ, Jordaan E, Botha U. Religious Delusions in a Xhosa Schizophrenia Population. Journal of religion and health. 2015;54(5):1555-62.
18.
Ensink K, Robertson B, Ben-Arie O, Hodson P, Tredoux C. Expression of schizophrenia in black Xhosa-speaking and white English-speaking South Africans. S Afr Med J. 1998;88:883–7.PubMed
19.
Patel V. Explanatory models of mental illness in sub-Saharan Africa. Soc Sci Med. 1995;40(9):1291–8.CrossRefPubMed
20.
Mbanga N, Niehaus D, Mzamo N, Wessels C, Allen A, Emsley R, et al. Attitudes towards and beliefs about schizophrenia in Xhosa families with affected probands. Curationis. 2002;25(1):69–73.CrossRefPubMed
21.
Niehaus D, Oosthuizen P, Lochner C, Emsley R, Jordaan E, Mbanga N, et al. A culture-bound syndrome'amafufunyana'and a culture-specific event'ukuthwasa': differentiated by a family history of schizophrenia and other psychiatric disorders. Psychopathology. 2004;37:59–63.CrossRefPubMed
22.
Chimusa ER, Meintjies A, Tchanga M, Mulder N, Seioghe C, Soodyall H, et al. A Genomic Portrait of Haplotype Diversity and Signatures of Selection in Indigenous Southern African Populations. PLoS Genet. 2015;11(3):e1005052-e.CrossRef
23.
South African Institute of Race Relations. South African Survey 2014/2015. IRR, South Africa; 2015.
24.
Botha UA, Koen L, Niehaus DJ. Perceptions of a South African schizophrenia population with regards to community attitudes towards their illness. Soc Psychiatry Psychiatr Epidemiol. 2006;41(8):619–23.CrossRefPubMed
25.
Hugo CJ, Boshoff DE, Traut A, Zungu-Dirwayi N, Stein DJ. Community attitudes toward and knowledge of mental illness in South Africa. Soc Psychiatry Psychiatr Epidemiol. 2003;38(12):715–9.CrossRefPubMed
26.
Ashforth A. AIDS, witchcraft, and the problem of power in post-apartheid South Africa. School of Social Science. 2001
27.
Golooba‐Mutebi F. Witchcraft, social cohesion and participation in a South African village. Dev Change. 2005;36(5):937–58.CrossRef
28.
Bührmann M. Thwasa and bewitchment. S Afr Med J. 1982;61(23):877–9.PubMed
29.
Davids D, Blouws T, Aboyade O, Gibson D, De Jong JT, Van’t Klooster C, Hughes G. Traditional health practitioners’ perceptions, herbal treatment and management of HIV and related opportunistic infections. J Ethnobiol Ethnomed. 2014;10(1):1.CrossRef
30.
Schweitzer R. A phenomenological study of dream interpretation among the Xhosa-speaking people in rural South Africa. J Phenomenol Psychol. 1996;27(1):72–96.CrossRef
31.
Mzimkulu KG, Simbayi LC. Perspectives and Practices of Xhosa‐speaking African Traditional Healers when Managing Psychosis. Int J Disabil Dev Educ. 2006;53(4):417–31.CrossRef
32.
Lund C, Swartz L. Xhosa-speaking schizophrenic patients' experience of their condition: psychosis and amafufunyana. S Afr J Psychol. 1998;28(2):62–70.
33.
Ripke S, Neale BM, Corvin A, Walters JT, Farh K-H, Holmans PA, et al. Biological insights from 108 schizophrenia-associated genetic loci. Nature. 2014;511(7510):421.CrossRefPubMedCentral
34.
Jeste DV, Palmer BW, Appelbaum PS, Golshan S, Glorioso D, Dunn LB, et al. A new brief instrument for assessing decisional capacity for clinical research. Arch Gen Psychiatry. 2007;64(8):966–74.CrossRefPubMed
35.
First M, Spitzer R, Gibbon M, Williams J. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinician Version, Administration Booklet. American Psychiatric Pub. 2012
36.
Gur RC, Richard J, Hughett P, Calkins ME, Macy L, Bilker WB, Brensinger C, Gur RE. A cognitive neuroscience-based computerized battery for efficient measurement of individual differences: standardization and initial construct validation. J Neurosci Methods. 2010;187(2):254–62.CrossRefPubMed
37.
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169–90.CrossRefPubMed
38.
Brohan E, Clement S, Rose D, Sartorius N, Slade M, Thornicroft G. Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC). Psychiatry Res. 2013;208(1):33–40.CrossRefPubMed
39.
Sartorius N, Janca A. Psychiatric assessment instruments developed by the World Health Organization. Soc Psychiatry Psychiatr Epidemiol. 1996;31(2):55–69.CrossRefPubMed
40.
Mosotho L, Louw D, Calitz FJ. Schizophrenia among Sesotho speakers in South Africa. Afr J Psychiatry. 2011;14(1):50–5.CrossRef
41.
Maslowski J, Rensburg DJ, Mthoko N. A polydiagnostic approach to the differences in the symptoms of schizophrenia in different cultural and ethnic populations. Acta Psychiatr Scand. 1998;98(1):41–6.CrossRefPubMed
42.
Lewis-Fernández R, Aggarwal NK, Bäärnhielm S, Rohlof H, Kirmayer LJ, Weiss MG, et al. Culture and psychiatric evaluation: operationalizing cultural formulation for DSM-5. Psychiatry. 2014;77(2):130–54.CrossRefPubMedPubMedCentral
43.
Nwoye A. African psychology and the Africentric paradigm to clinical diagnosis and treatment. South African Journal of Psychology. 2015;45(3):305-317.
44.
Susser E, Patel V. Psychiatric epidemiology and global mental health: joining forces. International journal of epidemiology. 2014:dyu053.
45.
Garety PA, Freeman D, Jolley S, Dunn G, Bebbington PE, Fowler DG, Kuipers E, Dudley R. Reasoning, emotions, and delusional conviction in psychosis. J Abnorm Psychol. 2005;114(3):373–84.CrossRefPubMed
Metadata
Title
The content of delusions in a sample of South African Xhosa people with schizophrenia
Authors
Megan M. Campbell
Goodman Sibeko
Sumaya Mall
Adam Baldinger
Mohamed Nagdee
Ezra Susser
Dan J. Stein
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1196-3

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

The role of metacognition and obsessive-compulsive symptoms in psychosis: an analogue study

Research article

Anger management in substance abuse based on cognitive behavioral therapy: an interventional study

Research article

The health and wellbeing needs of veterans: a rapid review

Research article

Depression: point-prevalence and risk factors in a North Cyprus household adult cross-sectional study

Research article

Comparison and predictors of treatment adherence and remission among patients with schizophrenia treated with paliperidone palmitate or atypical oral antipsychotics in community behavioral health organizations

Research article

Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity