Ethnomedical Syndromes and Treatment-Seeking Behavior among Mayan Refugees in Chiapas, Mexico

Abstract

This survey investigated the prevalence of ethnomedical syndromes and examined treatments and treatment-seeking in Mayan Guatemalans living in United Nations High Commissioner for Refugee (UNHCR) camps in Chiapas, Mexico. Methods included a rapid ethnographic assessment to refine survey methods and inform the cross-sectional survey, which also examined mental health outcomes; 183 households were approached for interview, representing an estimated 1,546 residents in five refugee camps and 93% of all households. One adult per household (N = 170) was interviewed regarding his or her health; an additional 9 adults in three surveyed households participated and were included in this analysis; of the 179 participants, 95 primary child-care providers also answered a children's health questionnaire for their children. Results indicated that ethnomedical syndromes were common in this sample, with 59% of adults and 48.4% of children having experienced susto (fright condition) and 34.1% of adults reporting ataques de nervios (nervous attacks); both conditions were significantly associated with symptoms consistent with posttraumatic stress disorder, anxiety and depression and are mental health conditions recognized by the American Psychiatric Association. Combining healthcare provider and indigenous treatments such as physician prescribed medication (65%), medicinal plants (65.7%), and limpias (spiritual cleansings) (40.6%) was reported. Most participants (86%) sought routine medical treatment from UNHCR trained health promoters in their camp. Assessing ethnomedical health is important for informing mental health programs among this population.

Susto: Etiology of Mental Disorders in Mothers and Children in Mexico

“…Susto has also been described as a Mexican Folk Illness, a Culture-Bound Syndrome (CBS). In more recent studies it has been called a Culturally Affiliated Syndrome, a Latin American Folk Syndrome, a Latin American Folk Illness, a Traditional Ethnomedical Concept that is broadly recognized by groups of Latin America, an Ethnomedical Syndrome that displays symptoms consistent with post-traumatic stress disorder, anxiety and depression as well as representing Idioms of Distress, often associated with psychiatric disorders, among Hispanic-American migrants (Durá-Vilá et al) [4,33,[38][39][40][41][42].…”

Ethnomedicine and ethnobotany of fright, a Caribbean culture-bound psychiatric syndrome

“…Finally, the Latin American concept of nervios ("nerves"), which stems from social overburden and conflict and includes sadness, anger, sleep troubles, hopelessness (see [22-25]), seems not unlike Caribbean descriptions of the circumstances and symptoms of "chronic fright." Like the two Caribbean fright varieties, ataques de nervios , susto , and nervios share some etiologies and symptoms with posttraumatic stress disorder, anxiety and depression as recognized by the American Psychiatric Association (see [20,26,27]).…”

Culture-bound syndromes in Spanish speaking Latin America: the case of Nervios, Susto and Ataques de Nervios

“…The articles reviewed indicate that the patients reporting having suffered Susto, Nervios or Ataques de Nervios present increased chances of having suffered depression, anxiety, panic disorders and PTSD 19,20,23,29,33,34,37 . However, the way these articles evaluate this is based on the reports of the individuals about their past, and so it carries the bias of memory and interpretation.…”

“…Four studies showed a relationship between posttraumatic stress disorder (PTSD) and Nervios/Ataques de Nervios 19,20,23,37 . Norris et al 20 studied Mexican victims of natural disasters, residents of Florida and Mexico itself, encoding the answers through consensus among different raters.…”