1
|
Ngubane NP, Mabandla MV, De Gama BZ. The antipsychotic potential of Salix Mucronata on ketamine-induced rats. IBRO Neurosci Rep 2024; 17:96-107. [PMID: 39040636 PMCID: PMC11261032 DOI: 10.1016/j.ibneur.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/09/2024] [Indexed: 07/24/2024] Open
Abstract
Salix mucronata is one of the herbal plants offered by the traditional health practitioners in KwaZulu-Natal, South Africa for the treatment of schizophrenia. This study aimed to investigate the effects of repeated administration of ketamine on social interaction, novelty and motivation in adult, male Sprague Dawley rats. It also aimed to investigate the potential of risperidone and the herbal extract of S. mucronata to reverse impairments that are induced by ketamine. Experimental rats (n=45) received a dose of ketamine at 30 mg/kg via intraperitoneal injection for 5 consecutive days. They were then allocated into their respective treatment groups and given risperidone (APD) and the herbal extract of S. mucronata (TM) at doses of 6 mg/kg and 5 mg/kg, respectively, for 7 consecutive days. Social behaviour was tested using the 3-chambered sociability test, and anhedonia was tested using the sucrose preference test. Ketamine induction elicited social withdrawal and reduced social novelty which were later successfully reversed by risperidone and S. mucronata. The rats showed reduced preference to sucrose post-induction and post-treatment. Ketamine and mild stress caused by scruff restraint elicited reduced weight gain for the animals. No differences were noted on brain mass between controls and experimental groups and also between risperidone and S. mucronata groups. However, reduced brain volume was noted in experimental groups. Dopamine and acetylcholine concentration levels were high in groups which received risperidone and S. mucronata. These findings highlight that the antipsychotic potential of S. mucronata is similar to risperidone.
Collapse
Affiliation(s)
- Ntombifuthi P. Ngubane
- Discipline of Clinical Anatomy School of Laboratory Medicine and Medical Sciences College of Health Sciences University of KwaZulu-Natal Westville Campus, Private Bag X54001, Durban 4000, South Africa
| | - Musa V. Mabandla
- Discipline of Physiology School of Laboratory Medicine and Medical Sciences College of Health Sciences University of KwaZulu-Natal Westville Campus, Private Bag X54001, Durban 4000, South Africa
| | - Brenda Z. De Gama
- Discipline of Clinical Anatomy School of Laboratory Medicine and Medical Sciences College of Health Sciences University of KwaZulu-Natal Westville Campus, Private Bag X54001, Durban 4000, South Africa
| |
Collapse
|
2
|
Ngubane NP, De Gama BZ. The Influence of Culture on the Cause, Diagnosis and Treatment of Serious Mental Illness (Ufufunyana): Perspectives of Traditional Health Practitioners in the Harry Gwala District, KwaZulu-Natal. Cult Med Psychiatry 2024; 48:634-654. [PMID: 38909336 PMCID: PMC11362295 DOI: 10.1007/s11013-024-09863-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/24/2024]
Abstract
Cultural beliefs influence the perceived cause, methods of diagnosis and treatment of mental illnesses. A qualitative study was conducted among traditional health practitioners (THPs) in the Harry Gwala District Municipality to further explore this influence. Purposive sampling assisted in the recruitment of 31 participants (9 males and 22 females). The four key themes this study investigated in relation to mental illness included its causes, methods of diagnosis, common symptoms observed and treatment approaches used by THPs, and the system of patient management. Culturally, mental illness was reported to be caused by witchcraft and an ancestral calling in this study. Mental illness was predominantly diagnosed by spiritual intervention which included divination through consultation with the ancestors, familial background, burning of incense which can also be part of communicating with the ancestors and through examining the patient. The common symptoms included aggression, hallucination and unresponsiveness. Prevalent modes of treatment included the use of a medicinal concoction and performing cultural rituals where ancestors and other spirits were assumed influential. The duration of the treatment process was dependent on guidance from the ancestors. Most causal aspects of mental illness from diagnosis to treatment seemed to be influenced by cultural beliefs and ancestors.
Collapse
Affiliation(s)
- Ntombifuthi P Ngubane
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
| | - Brenda Z De Gama
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
| |
Collapse
|
3
|
Galvin M, Chiwaye L, Moolla A. Religious and Medical Pluralism Among Traditional Healers in Johannesburg, South Africa. JOURNAL OF RELIGION AND HEALTH 2024; 63:907-923. [PMID: 36971902 PMCID: PMC10040931 DOI: 10.1007/s10943-023-01795-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted with 18 THPs in Johannesburg, South Africa between January and May, 2022. Interviews were transcribed and translated into English. Data were managed using NVivo 12 software and thematically analyzed. The majority of THPs interviewed indicated that initiation as a THP was almost always preceded by a sickness accompanied by dreams/visions that represented an "ancestral calling" to become a healer. Most THPs also trained as both sangomas-who healed according to traditional beliefs-and prophets-who healed according to Christian beliefs. This reflects a syncretic relationship between traditional African beliefs and Christianity. However, not all churches are accepting of traditional beliefs and subsequently these THPs are members only at non-Pentecostal AIC churches who blend both African and Christian practices. Similar to these forms of religious pluralism melding Christianity and traditional beliefs, many THPs also often practice medical pluralism, mixing Western treatments with traditional practices/medicines. THPs are able to adapt elements of Western and African beliefs into healing practices that span multiple religious and medical fields. Thus, collaborative and decentralized healthcare services may be highly acceptable among such a pluralistic community.
Collapse
Affiliation(s)
- Michael Galvin
- Health Economics and Epidemiology Research Office (HE2RO), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Psychiatry, Boston Medical Center (BMC), Boston, USA.
- Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Lesley Chiwaye
- Health Economics and Epidemiology Research Office (HE2RO), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aneesa Moolla
- Health Economics and Epidemiology Research Office (HE2RO), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Ngubane NP, De Gama BZ. A quantitative evaluation of traditional health practitioners’ perspectives on mental disorders in KwaZulu-Natal: knowledge, diagnosis, and treatment practices. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2023. [DOI: 10.1080/19349637.2023.2194561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
|
5
|
van der Zeijst MCE, Veling W, Makhathini EM, Mbatha ND, Shabalala SS, van Hoeken D, Susser E, Burns JK, Hoek HW. Course of psychotic experiences and disorders among apprentice traditional health practitioners in rural South Africa: 3-year follow-up study. Front Psychiatry 2022; 13:956003. [PMID: 36245859 PMCID: PMC9558832 DOI: 10.3389/fpsyt.2022.956003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Culture is inevitably linked with the experience, interpretation and course of what modern biomedicine understands to be psychotic symptoms. However, data on psychoses in low- and middle-income countries are sparse. Our previous study showed that psychotic and mood-related experiences, symptoms and disorders are common among individuals who had received the ancestral calling to become a traditional health practitioner (THP) in rural KwaZulu-Natal, South Africa. Our related ethnographic study suggested that ukuthwasa (the training to become a THP) may positively moderate these calling-related symptoms. As far as we know, no research has been conducted into the course of psychiatric symptoms among apprentice THPs. Objective We studied the course of psychotic experiences, symptoms and disorders among apprentice THPs. We also assessed their level of functioning and expanded our knowledge on ukuthwasa. Materials and methods We performed a 3-year follow-up of a baseline sample of apprentice THPs (n = 48). Psychiatric assessments (CAPE, SCAN), assessment of functioning (WHODAS) and a semi-structured qualitative questionnaire were completed for 42 individuals. Results At 3-year follow-up, psychotic experiences were associated with significantly less distress and there was a reduction in frequency of psychotic symptoms compared to baseline. The number of participants with psychotic disorders had decreased from 7 (17%) to 4 (10%). Six out of seven participants (86%) with a psychotic disorder at baseline no longer had a psychiatric diagnosis at follow-up. Although the mean level of disability among the (apprentice) THPs corresponded with the 78th percentile found in the general population, 37 participants (88%) reported no or mild disability. Forty-one participants (98%) reported that ukuthwasa had positively influenced their psychiatric symptoms. Conclusion In rural KwaZulu-Natal, psychotic experiences, symptoms and disorders have a benign course in most individuals who are undergoing the process of becoming a THP. Ukuthwasa may be an effective, culturally sanctioned, healing intervention for some selected individuals, potentially because it reframes distressing experiences into positive and highly valued experiences, reduces stigma, and enhances social empowerment and identity construction. This implies that cultural and spiritual interventions can have a positive influence on the course of psychosis.
Collapse
Affiliation(s)
| | - Wim Veling
- Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - Elliot M. Makhathini
- Department of Nursing, Durban University of Technology, Pietermaritzburg, South Africa
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Ndukuzakhe D. Mbatha
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sinethemba S. Shabalala
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Jonathan K. Burns
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Hans W. Hoek
- Parnassia Psychiatric Institute, The Hague, Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| |
Collapse
|
6
|
Gureje O, Ojagbemi A. Applicability and future status of schizophrenia as a construct in Africa. Schizophr Res 2022; 242:52-55. [PMID: 35151534 DOI: 10.1016/j.schres.2022.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Nigeria; Department of Psychiatry, Stellenbosch University, South Africa.
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Nigeria
| |
Collapse
|
7
|
Ojagbemi A, Gureje O. Sociocultural contexts of mental illness experience among Africans. Transcult Psychiatry 2021; 58:455-459. [PMID: 34427458 DOI: 10.1177/13634615211029055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
8
|
van der Zeijst M, Veling W, Makhathini EM, Susser E, Burns JK, Hoek HW, Susser I. Ancestral calling, traditional health practitioner training and mental illness: An ethnographic study from rural KwaZulu-Natal, South Africa. Transcult Psychiatry 2021; 58:471-485. [PMID: 32151201 DOI: 10.1177/1363461520909615] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This qualitative ethnographic study complements an epidemiological study on first episode psychosis in Vulindlela, a rural area in KwaZulu-Natal, South Africa. It focuses on two themes that emerged from our data: (1) the calling of the ancestors to become a traditional health practitioner and (2) ukuthwasa, the training to become a traditional health practitioner. The purpose of this study is to describe the ancestral calling, and to explore whether ukuthwasa may help with the management of mental disturbances, including unusual perceptual experiences. We also provide a discussion of the changing sociopolitical context of healing in KwaZulu-Natal, as a background to our study. In-depth interviews were conducted with 20 (apprentice) traditional health practitioners, formal health practitioners, patients and relatives recruited through local traditional health practitioners and a health care clinic. Our results show that the ancestral calling might announce itself with symptoms of mental illness including unusual perceptual experiences, for which some participants consider ukuthwasa as the only effective cure. We found indications that in some individuals successful completion of ukuthwasa might promote recovery from their illness and lead to a profession in which the unusual perceptual experiences become a legitimate and positively valued aspect. We suggest that - in this particular community today, which has been subject to several sociopolitical changes - ukuthwasa may be a culturally sanctioned healing process which moderates experiences that a Western psychiatric system might characterize as psychotic symptoms, providing some individuals with a lucrative and respected role in society.
Collapse
Affiliation(s)
| | | | | | - Ezra Susser
- Columbia University.,27424New York State Psychiatric Institute
| | - Jonathan K Burns
- University of KwaZulu-Natal.,171002University of Exeter Medical School
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Netherlands.,University of Groningen.,Columbia University
| | - Ida Susser
- Columbia University.,City University of New York
| |
Collapse
|