• http://www.headstraight.co.za Dassie

    I think most psychologists and psychiatrists in SA use DSM-IV or ICD-10 for diagnosing mental disorders. DSM-IV already has a number of culturally specific disorders and complaints such as “Brain Fag” and “Koro”. I’m not sure about ICD-10. I’d be interested to know if there are any specific to southern Africa listed or if there will be with DSM-V.
    Ukuthwasa, for instance, while perhaps not always an unwanted experience, can apparently be quite debilitating. I wonder if there are any mental health professionals in SA who have given sick notes for such culturally specific problems? Is it conceivable that a diagnosis for a culture bound syndrome might be given, treatment sought, medical aid claims made and so on? Fascinating! My initial feeling is that this has to be nonsense, but I’m not sure if I’m being prejudiced. If a mental health professional believes someone is delusional and books them off sick, is it the same thing as book them off sick when they believe they have been called by the ancestors to be a Sangoma and are experiencing a “creative illness”? How one measures whether distress is real and to what extent it causes a debilitating condition… seems to subjective in both cases.

    • http://synapses.co.za Jacques Rousseau

      Some very interesting issues indeed, Dassie. Though I imagine the distress is “real” in the vast majority of cases, even if it’s induced by some confusion or other. So, we could have the situation whereby it’s legitimate to book someone off work on the grounds of something they do feel, but wouldn’t in an ideal world (at least, my version of it). The courts are a related, but separate, question – should they be neutral on this? And as you say, is there a valid distinction to be made between various (culturally specific) forms of delusion here? Fascinating indeed, and you’ve highlighted to me that my initial reaction had some prejudice in it – I think I’m programmed to see certain classified disorders as more serious than others, perhaps on shaky ground.

      On the DSM or ICD – I’ll want to re-look that now. Even though there are culturally-specific disorders listed, I remember them being synonyms, rather than unique disorders.