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Causal attributions, pathway to care and clinical features of first-episode psychosis: A South African perspective

Author

Listed:
  • Jonathan K. Burns

    (Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, burns@ukzn.ac.za)

  • Khatija Jhazbhay

    (Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa)

  • Robin A. Emsley

    (Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa)

Abstract

Background: Causal belief systems and help-seeking practices may impact on pathway to care and features of first-episode psychosis (FEP) that have prognostic value. This is particularly relevant in South Africa where many people subscribe to traditional belief systems and consult traditional healers. Aim: To evaluate the relationship between causal attributions and pathway to care and features of FEP that have prognostic value. Method: We tested associations between causal attributions and pathway to care and duration of untreated psychosis (DUP), age of onset, PANSS-rated positive, negative and general symptoms and depressive symptoms (Calgary Depression Scale) in a sample of 54 FEP patients. Results: Spiritual attribution of cause (49% of patients) was associated with long DUP, while consultation with a traditional healer (39% of patients) was associated with long DUP and high negative symptoms. Only 19% had consulted a psychiatrist. Seventy nine per cent (79%) were referred to hospital by family, police were involved in 44% of admissions, and 81% were admitted involuntarily. Conclusions: Spiritual attributions of cause and previous consultation with traditional healers may delay entry to psychiatric care and thereby negatively impact on prognosis of FEP. This highlights the importance of mental health education and developing a positive collaborative relationship with traditional healers, especially in low- and middle-income countries.

Suggested Citation

  • Jonathan K. Burns & Khatija Jhazbhay & Robin A. Emsley, 2011. "Causal attributions, pathway to care and clinical features of first-episode psychosis: A South African perspective," International Journal of Social Psychiatry, , vol. 57(5), pages 538-545, September.
    • Handle: RePEc:sae:socpsy:v:57:y:2011:i:5:p:538-545
    DOI: 10.1177/0020764010390199
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    Cited by:

    1. Kristian L Toftegaard & Lea Nørgreen Gustafsson & Richard Uwakwe & Ulla A Andersen & Thomas Becker & Graziella Giacometti Bickel & Bernhard Bork & Joachim Cordes & Karel Frasch & Bent Ascanius Jacobs, 2015. "Where are patients who have co-occurring mental and physical diseases located?," International Journal of Social Psychiatry, , vol. 61(5), pages 456-464, August.
    2. Michael Galvin & William Byansi & Lesley Chiwaye & Zoleka Luvuno & Aneesa Moolla, 2023. "Pathways to care among patients with mental illness at two psychiatric facilities in Johannesburg, South Africa," International Journal of Social Psychiatry, , vol. 69(8), pages 2059-2067, December.

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