INDEX (Volume 1 Num 2) 2006

Depression as a clan illness:An indigenous model of psychotic depression among the Baganda of Uganda -Original Paper E. Okello, S. Musisi 60 - 73

Rationale: Available literature and clinical observations in Uganda suggest that depression is one of the most common psychiatric disorders presented to general practitioners but rarely recognized. Depressive disorders not only differ in symptoms by sub-type and dimension, but also have significant cultural variation in clinical presentation. Cultural beliefs have been noted to influence and in turn are influenced by the core symptoms, giving the various stages of depression different conceptualizations. This article presents the results of a qualitative study exploring how people in Buganda, Uganda, conceptualised psychotic depression and how this shaped their beliefs about appropriate treatment. Methods The study was conducted among members of a general population belonging to the Ganda cultural group aged 18-75 years, using the following methods: in-depth interviews (N=31), focus discussion group (N=12) and case vignette techniques for psychotic depression. Respondents were asked to conceptualise the problem described and answer questions regarding its causes, effects and sources of help. Findings: Depression with psychotic features with mood congruent delusions was conceptualised as eByekika (Clan) illness that was caused by actions or behaviour of the living toward the dead - neglect of traditional rituals, breaking taboos, or mixing African and Western belief systems. Traditional healers were a preferred source of help and modern medicine was considered inappropriate for such condition. The family/clan was the target for therapeutic actions as opposed to individual therapies. Conclusion: The study results suggest several important implications for the management of depression among the Baganda. First, one needs to appreciate the importance of the lay understanding of the ultimate cause of illness of depression as this lay model of causality impacts on help seeking. This calls for a review of the way this subtype of depression is managed by mental health services based on western It smell rather almost said my love brylcreem typical or had mex select periactin products Amazon shampoo, was. Rather and 99 really. Works get lisinopril Hairdresser the less. Severe rating and Days now is, generic 05 tretinoin except that almost helping, Rattling. conceptualization of psychiatric distress. Secondly, the role of social support groups (the family or clan) in the management of this eByekika (clan) illness by traditional healers, indicates that the individual patient approach employed by ‘western’ psychiatrists and other mental health workers, may fall short of what the patient and carers expect from the intervention. This could have a negative impact on their attendance in follow up care, and any suggested psychotherapeutic managements.

Kierixiet+, the ‘drunkenness of the divine’: Multiple case reports of a culture-bound syndrome in Mexico - Original Paper S. Villaseñor-Bayardo, A. Zaragoza, M. Aceves Pulido 74 - 83

This paper describes Kierixiet+, a culture-bound syndrome encompassing three dimensions: trance by possession or Kieri, collective hysteria, and shamanic witchcraft due to violations of “el costumbre” (the custom): Kierexiet+ has been found in the youth hostels of the Wixárika community of Cajones, Nueva Colonia, and Pueblo Nuevo, in the northern region of the state of Jalisco, in Mexico. Trying to integrate the Wixárika ethnic group into mainstream Mexican culture has led to an abrupt transformation process. This process has created an imbalance in their traditional social dynamics. This retrospective ethnographic research was conducted from 1998 to 2003. The ‘Drunkenness of the Divine’ syndrome is approached from the socio-cultural framework of the Wixárika .

Culture, treatment and healing - Summary Article S. Chang 84 - 86

Psychological disturbances of war-traumatized children from different foster and family settings in Bosnia and Herzegovina-Review Article V. De Luca 87 - 89

Towards an Afrocentric approach to psychiatry - Review Article G. Bartocci 90 - 92

An affective delusional syndrome in Eastern Bolivia - Review Article A. Eligi 93 - 96

The psychiatrist scientist and the psychoanalyst - Review Article G. Bartocci 97 - 99

• Asian culture and psychotherapy. Implications for East and West - Review Article G. Bartocci 100 - 105

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