Etat des lieux des soins de premier recours des malades mentaux à Antananarivo : étude rétrospective

摘要

Religion and traditional healers still occupy a prominent place in the management of mental ill subjects in Madagascar. This study aimed to assess primary care for mentally ill subjects. We conducted a retrospective descriptive study in the Department of Psychiatry at the University Hospital Befelatananain, Antananarivo over a period of 16 months from January 2014 to April 2015. The prevalence of psychosis was estimated to be 25%. Feminine gender (53%), merina ethnicity (77%), students (45%), a secondary school qualification (40%), singles (72%), Protestantism (45%) as well as an average socio-economic level (57.5%) were predominant. Clinical parameters mainly included an abrupt onset (52%), a first invocation to religion (40%), and a history of similar cases (90%). Schizophrenia was the most frequent disease in half of the cases. The median improvement time under both traditional and religious treatments was more than 10 days in hospital. The patients who underwent early psychiatric care improved in less than 10 days in 75% of cases. A delay in psychiatric care is a reality in Madagascar which aggravates the prognosis of patients with psychosis.