Chronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based cross-sectional study

Abstract

BackgroundOutbreaks of mass psychogenic illness (MPI), which are a constellation of physical signs and symptoms suggestive of organic illness with no identifiable causes. MPI has been documented in numerous cultural, ethnic, and religious groups throughout the world. The aims of this study were to document the nature and impacts of the illness, to assess interventions, and to come up with recommendations and management formulations for dealing with such kinds of outbreaks in the future.MethodsCommunity based cross-sectional study was conducted in June, 2015 in Derashe Woreda, Segen Area People Zone of the Southern Nations Nationalities and People’s Region. Women with complaints of breast cancer but with no objective findings were the subjects of the study. Ninety-seven women were investigated using a semi-structured questionnaire for quantitative study. Two focus group discussions with seven affected and seven non-affected women and four key informant interviews were conducted using guiding questionnaires. Quantitative data was analyzed using SPSS version 20 software packages while qualitative data was analyzed manually going through thematic areas.ResultThe ages of the ninety-seven study participants ranged from 17 to 56 years, with a mean (SD) of 32.8 (8.7) years. Onset of illness was dated back to the year 2012 following the death of a 43 year old socially active woman with complications of breast cancer. Following her death many women started to report multiple vague physical complaints similar to those of the deceased woman. Even though the responses from the study participants did not specifically point to a single possible cause and means of transmission, high numbers of women believed the source of their illness could be punishment from God while some said that the cause of their suffering could be environmental pollution. Since the illness was taken to be contagious, affected women faced stigma and discrimination. Moreover, school activities and social gatherings were limited significantly.ConclusionUnrealistic and exaggerated rumors and inadequate explanations about the nature and spread of the illness were the main contributing factors for the spread and prolongation of the outbreak. An organized intervention, clear and adequate explanations about the nature and transmission of the illness can contain MPI within a short period of time.

Mass Psychogenic Illness in Haraza Elementary School, Tigray, Northern Ethiopia: Investigation to the nature of an Episode.

“…This type of frequent attack of teenage females groups were reported from similar study settings [8,17,37]. Such outbreak lead a very rapid spread of symptoms which frequently includes chilling, fear, crying and shouting, laughing, anxiety, abdominal pain, communication difficulties, laughing, generalized weakness, muscle cramp and fainting which is consistent with other similar studies [8,[15][16][17][18].…”

“…In Africa evil spirit, witchcraft, Satanism or failures to perform cultural and religious rituals have been mentioned as the causes of the illnesses [5]. Similar finding was reported from Kombolcha of Northern Ethiopia, Derashe of Southern Ethiopia, [17][18]. On the other hand toxic chemicals and environmental pollution have been notified in western setting; India due to toxic fumes [13], these attributions in Africa, lead many victims commonly seek treatment from different religious and traditional healing sites [13][14][15][16][17][18].…”

“…In some cases, card review was done to summarize patient history and other investigations done during hospital admission in order to rule out recent underlying medical illnesses and organic causes. Key informant interviews were facilitated using guiding questionnaire adopted from similar study conducted in Dershe district of Southern Ethiopia [18]. Home to home interviews were conducted with families of index case and community members.…”

“…Among these, 20% of them felt ill by only seeing other ill students in the school [16]. Satanism and evil devil force, punishment by God, due to the presence of toxic chemicals, polluted environment, cold air, and using family planning injection or pills had been discovered around the schools and community members in Ethiopia [16][17][18][19].…”

“…On the other hand toxic chemicals and environmental pollution have been notified in western setting; India due to toxic fumes [13], these attributions in Africa, lead many victims commonly seek treatment from different religious and traditional healing sites [13][14][15][16][17][18]. This is also practice in Ethiopia context in which more than half (63.9%) of study participants in Derashe district of Southern Ethiopia reported that they had been visiting traditional healing services, 8.2% had sought treatment from religious services, 75.3% modern health service, 5.1%, all the three treatment sites, namely traditional healers, religious healers and health institutions [18].…”