Mental Health in Africa: II. the Nature of Mental Disorder in Africa Today

Abstract

Aspects of clinical psychiatric syndromes described in Africa which are discussed include the issue of schizophrenic disorders having a better prognosis in developing countries; controversy over this is by no means at an end. There is an increasing realisation as to the frequency of affective disorders in Africa; while somatisation is common, cherished beliefs, such as the absence of guilt, have not been confirmed by more recent research. Nor is suicide as infrequent as has been suggested. The relationship of background physiological abnormalities of cerebral functioning may be relevant to some of the clinical issues that are currently under discussion in African psychiatry.

Cultural Variations in Hopelessness, Optimism, and Suicidal Ideation: A Study of Ghana and U.S. College Samples

“…Specifically, their report indicated that suicide rates were highest in Hungary, and lowest in countries in Africa, Asia, and Latin America. These findings confirm earlier reports of low suicide rates in African countries (German, 1987). In his report, German explained that low suicide rates in African countries may be due to negative attitudes towards suicide in these countries.…”

Performance of the Diagnostic Interview Schedule for Children Version 2.3 (DISC‐2.3) in an Informal Settlement Area in South Africa

“…On the one hand, for instance, somatoform and dissociative mechanisms have been cited as common in African society (Ensink and Robertson, 1996;Guinness, 1992), but the DISC-2.3 does not have modules for somatoform or dissociativedisorders. On the other hand, eating disorders and OCD appear to be virtually unknown in traditional African communities (German, 1987;Ilechukwu, 1991;Minde and Nikapora, 1993).…”

Depressive Symptomatology and Short-Term Stability at a Nigerian Psychiatric Care Facility

“…In particular, the prevalence of feelings of guilt remains the same (13.5%); along with delusions of guilt they are the least common symptoms, in line with the long-standing impression of the uncommoness of these symptoms among Africans [10]. Commenting on a Ugandan study that reported four times greater prevalence of pathological guilt than a London sample, German [35] opined that this may represent a constellation of symptoms peculiar to a particular area. Also, it has been noted that the relatively high level of alcoholism in East and Southern Africa could affect the content of depressive symptomatology in these subregions, with a possible increase in feelings of guilt and suicidal behaviour [11].…”