The pattern of delusions in a cross-cultural hospital population was studied. It was found that there were cultural differences in persecutory, grandiose and religious, and sexual and fantastic delusions, accounted for mainly by the relatively higher frequencies in the African and West Indian cultural groups. These phenomena can be understood in terms of the cultural backgrounds of these groups. It is further argued that similarly defined persecutory delusions have a wide clinical significance that goes beyond schizophrenia in some cultural groups.
The frequencies of auditory, visual and olfactory hallucinations as defined by Wing et al. were studied in schizophrenic patients of various groups treated in the same hospital. The diagnosis of schizophrenia was made by the use of the Syndrome Check List. It was found that there were some cultural differences in the frequencies of hallucinations, these being higher in the African, West Indian and Asian culture groups than in the English and other groups. The possible clinical significance of these variations are discussed.
Thirty Kenyan patients of black African origin undergoing treatment for clinical depression in Nairobi, and 40 matched non-psychiatrically disturbed controls in the community were studies for life events using the Brown-Harris model. It was found that the depressed group had significantly more life events (P less than 0.001 with Yates correction for continuity) in the twelve months preceding the onset of their depression than the controls in the same period. These results are similar to those obtained by several workers in Western settings. Their implication for the practice of psychiatry in an African context is examined, and some myths about psychiatry in Africa re-examined.
In a controlled study of life events in Kenya it was found that events related to education and health were significantly more common in depressed than non-depressed subjects. The patient or a member of his household was the most common focus of the .events. The events were mostly undesirable, mainly in the form of a loss. These observations are compared and contrasted with observations made elsewhere.
In a controlled study of life events in depressed patients in Kenya it was found that the rate of life events was higher in the depressed group in the 27 weeks preceding the onset of depression but with a sharp increase in the last 6-9 weeks before onset. It was also found that the depressed patients continued to experience independent life events after the onset of the depression. It is hypothesized that the continued occurrence of life events after the onset of depression is an incentive to seek help and, eventually, a psychiatric referral.
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