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Title: Role of traditional healers in the pathway to care of patients with bipolar disorder in Egypt
Author: Tarek Assad, Tarek Okasha, Hisham Ramy, Tamer Goueli, Hanan El-Shinnawy, Mohamed Nasr, Heba Fathy, Dalia Enaba, Dina Ibrahim, Mahmoud Elhabiby, Nesreen Mohsen, Sherien Khalil, Mohamed Fekry, Nivert Zaki, Hani Hamed, Hanan Azzam, Marwa A Meguid, Menan AbdelMaksoud Rabie, Marwa Sultan, Soheir Elghoneimy, Osama Refaat, Doaa Nader, Doha Elserafi, Marwa Elmissiry and Iman Shora
Abstract:
Abstract Background: A large number of mentally ill patients prefer to visit non-medical practitioners such as traditional healers because of the confidence in the system, affordability and accessibility of the service. This may lead to delay in seeking psychiatric services and has prognostic impact. Aim: To assess the rate of bipolar affective disorder (BAD) patients seeking traditional healers, the sociodemographic and clinical correlates of those patients. Methods: We assessed 350 patients with BAD after confirmation of diagnosis with Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) research version and assessment of functioning with Global Assessment of Functioning scale. They were assessed for percent, rate and timing of seeking traditional healers. Results: In all, 40.8% sought traditional healers, with 34.9% more than four times. Of those, 62.2% were before seeking psychiatric services and 37.8% after. Lower educational level, less impairment of functioning and presence of hallucinations were significant correlates. Conclusion: This study shows that most of the patients suffering from mental illness prefer to approach faith healers first, which may delay entry to psychiatric care and thereby negatively impact the prognosis of BAD. This highlights the importance of mental health education and developing a positive collaborative relationship with traditional healers. Keywords Traditional healers, bipolar patients, pathway to care
Distributor: International Journal of Social Psychiatry 2015, Vol. 61(6) 583–590
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