A retrospective review of lifetime prevalence of traditional healer consultation by an outpatient of Xhosa schizophrenia sufferers

This research report is submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Psychiatry.AIM: To describe the demographic and clinical characteristics of a group of patients of Xhosa ethnicity diagnosed with schizophrenia. To also determine the prevalence of their consultations with a traditional healer as well as the factors associated with an increased likelihood of such consultations. METHOD: The study was a review of a database originally compiled as part of an ongoing genetic study. Patients on the database were all of Xhosa ethnicity, with a diagnosis of schizophrenia and had all been recruited from community clinics and psychiatric hospitals in the Cape Town Metropole region. RESULTS: Data was extracted and analysed for 92 patients, who met the criteria for inclusion in this study. The majority of the patients were male (77.2%), single (88%) and unemployed (96%). The mean duration of illness was 20.5 years and the mean number of hospital admissions for their mental illness was 2.4. Close to half (43.5%) of the patients reported being non-compliant on their medication. Ten percent admitted to making one or more suicide attempts in their lifetime. Nicotine was the most commonly used substance (69.6%) followed by alcohol (55.4%), cannabis (37%) and methamphetamines (9.8%). Thirty eight percent of the patients reported having a traditional healer in their family. Twenty two percent had consulted with a traditional healer. In the bivariate analysis the following factors were significantly associated with consulting a traditional healer: having two or less psychiatric admissions (p=0.014); compliance on medication (p=0,012); and having a traditional healer in the family iii (p=0.005). When controlling for age, sex and marital status only having a traditional healer in the family was significantly associated with consulting traditional healer (p=0.011). CONCLUSIONS: This study found that a high proportion of the participants had consulted a traditional healer. This was significantly associated with having a traditional healer as a family member. It is recommended that programmes, to improve the mutual understanding and co-operation between Western practitioners and traditional healers and consequently mental health outcomes, need to be developed and implemented