Successful psychiatric treatment for rural Africans should incorporate their traditional belief that illness should be viewed in terms of magical, social, physical and religious parameters. Traditional healers divide illness into those of natural causation and those of traditional cultural aetiology which are peculiar to African people. Natural illness includes epilepsy, familial/genetic disorders, mental retardation and schizophrenia. Traditional, cultural disorders often cause difficulties for Western-trained psychiatrists because sorcery, spirit possession and ancestral worship are central to their aetiology and treatment as practised by traditional healers. They, in a state of altered consciousness, use a process of divination to determine why and from whom the misfortune originated. With this in mind, reputable traditional healers were consulted in therapy-resistant cases of culture-bound syndromes in Africans. Their high rate of success in treating these cases was notable. More recognition should be given to the reputable traditional healers.
In this study the authors researched cross-eultural identification of aggressive behaviour disturbances as identifying factors for patients' family members to seek professional help for the patients. Patients (N = 40), mainly Zulu-speaking were drawn from the outpatient clinic of a large academic general hospital. In all 23 (57,5%) of the patients and 25 (62,5%) of the relatives were urbanized. A comparison was made between what the patients' families considered problematic as opposed to formal professional diagnostic and aetiological considerations in the same patients. Several trends emerged from the results. It was demonstrated that the behavioural disturbances formed the most important set of identifying criteria for the family of the index patient. It held true for people in various stages of urbanization. Cognitive, mood and perceptual disturbances were of a lesser identifying value to families. Predictably, there were some differences between urban and rural families. Rural families were more attuned to the patient's problems but generally remained more tolerant of the aggressive behaviour and were less ready to seek professional help. These findings, some known from clinical observations and anecdotal communications, have seldom been objectively analysed -particularly in Africa. Implications for management, along with various related crosscultural issues, are discussed.In hierdie studie het die outeurs die kruis-kulturele identifikasie van aggressiewe gedragsverteurings nagevors as identifiserende faktore vir pasients se gesinslede om professionele hulp vir die pasianta te versoek. Pasisnta (N = 40), hoafsaaklik Zulusprekend, is geneem vanuit die buita-pasiente kliniek van 'n groat akademiese algemene hospitaal. 'n Totaal van 23 (57,5%) pasienta en 25 (62,5%) gesinslede was verstedelik. 'n Vergelyking is getref tussen wat die pasienta se gesinne as problematies beskou het teenoor formeIe professionele diagnostiese en etiologiese oorwegings in dieselfde pastente, Verskeie neigings is deur die resultate uitgelig. Dit is gedemonstreer dat die gedragsversteurings die belangrikste stel identifiseringskriteria vir die gesinne van die lndekspasiente was. Dit was die geval vir individue in verskeie stadia van verstedeliking. Kognitiewe, affektiewe en perseptuele versteurings was van minder identifikasie belang vir die gesinne. Soos voarspel kon word, was daar verskille tussen die verstedelikte en landelike gesinne. Landelike gesinne was meer ingestel op die pasienta se probleme, maar verdraagsamer teenoor die aggressiewe gedrag oar die algemeen en minder gewillig om professionele hulp te bekom. Die resultate, waarvan sommige bekend was a.g.v. kliniese observasies en anekdotiese kommunikasies, is nog seide objektief onteed veral in Afrika. Implikasies vir behandeling, sowel as verskeie kruis-kulturele aangeleenthede word bespreek.
This study reports on a cohort of 389 adult in-hospital parasuicides. The female to male ratio was 2,5:1,3. Age peaked between 20 -29 years with a decline corresponding with age advance. An increase in and a lowering of age in parasuicide were found. Most patients were married and had a history and family history of psychological problems including inordinate druglalcohol consumption. Self-poisoning by overdose predominated, with benzodiazepines, antidepressants, and non-narcotic analgesics being most common. A sex-linked difference in choice of method was evident. Adjustment disorders with depressed mood associated with interpersonal problems with a key person, substance abuse and social problems, and affective disorders were the most common psychiatric diagnoses. Increased subintentional parasuicide numbers were found. Results are discussed in terms of the implications these findings have for a clearer understanding of parasuicidal behaviour.
A short history of the use of exercise in Medicine is given. This is followed by the neurophysiological basis of exercise and its physical and psychological effects on motivation in man.
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