ArticleSocial psychiatry and psychiatric epidemiology2019
Identification of patients with recent-onset psychosis in KwaZulu Natal, South Africa: a pilot study with traditional health practitioners and diagnostic instruments.
Article in Social psychiatry and psychiatric epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The incidence of non-affective psychotic disorders in low and middle-income countries: a systematic review and meta-analysis.Social psychiatry and psychiatric epidemiology · 2023Pooled it
- Searching for people with psychosis in the global south: mapping and establishing a case surveillance system in South Africa (PSYMAP-ZN study).Social psychiatry and psychiatric epidemiology · 2026Article
- A scoping review to evaluate the efficacy of combining traditional healing and modern psychiatry in global mental healthcare.Global mental health (Cambridge, England) · 2025Review
- Early intervention in psychosis programs in Africa, Asia and Latin America; challenges and recommendations.Global mental health (Cambridge, England) · 2025Review
- Religious and Medical Pluralism Among Traditional Healers in Johannesburg, South Africa.Journal of religion and health · 2024Article
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- Psychosis screening questionnaire: Exploring its factor structure among South African adults.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2023Article
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- Course of psychotic experiences and disorders among apprentice traditional health practitioners in rural South Africa: 3-year follow-up study.Frontiers in psychiatry · 2022Article
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- Addressing the Needs of People with Schizophrenia in South Africa During the COVID-19 Pandemic.Schizophrenia bulletin open · 2022Review
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- Patient patronage and perspectives of traditional bone setting at an outpatient orthopaedic clinic in Northern Tanzania.African health sciences · 2021Article
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Authors and funding
12 authors.
Funding
Abstract
purposeThere is considerable variation in epidemiology and clinical course of psychotic disorders across social and geographical contexts. To date, very little data are available from low- and middle-income countries. In sub-Saharan Africa, most people with psychoses remain undetected and untreated, partly due to lack of formal health care services. This study in rural South Africa aimed to investigate if it is possible to identify individuals with recent-onset psychosis in collaboration with traditional health practitioners (THPs).
methodsWe developed a strategy to engage with THPs. Fifty THPs agreed to collaborate and were asked to refer help-seeking clients with recent-onset psychosis to the study. At referral, the THPs rated probability of psychosis ("maybe disturbed" or "disturbed"). A two-step diagnostic procedure was conducted, including the self-report Community Assessment of Psychic Experiences (CAPE) as screening instrument, and a semi-structured interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Accuracy of THP referrals, and test characteristics of the THP rating and the CAPE were calculated.
results149 help-seeking clients were referred by THPs, of which 44 (29.5%) received a SCAN DSM-IV diagnosis of psychotic disorder. The positive predictive value of a THP "disturbed" rating was 53.8%. Test characteristics of the CAPE were poor.
conclusionTHPs were open to identifying and referring individuals with possible psychosis. They recognized "being disturbed" as a condition for which collaboration with formal psychiatric services might be beneficial. By contrast, the CAPE performed poorly as a screening instrument. Collaboration with THPs is a promising approach to improve detection of individuals with recent-onset psychosis in rural South Africa.
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