Aims: To understand the patterns of the schizophrenic patients' healthcare-seeking behaviour (HCSB) in the context of a post-conflict country where psychiatric facilities are scarce.
Methods: Cross-sectional survey assessing schizophrenic patients and their caregivers who consulted for the first time in four different outpatient psychiatric departments.
Results: One hundred and four schizophrenic patients were selected: 56.7% began the HCSB with traditional medicine; 22.1% with western medicine, psychiatry included, and 20.2% with religious medicine; 77.3% did not begin the HCSB with psychiatry because they did not know it was a mental problem or because they did not know mental health services existed. The patients' education was the only factor that significantly influenced the HCSB.
Conclusion: In Cambodia, traditional and religious medicine are the first pathway to mental healthcare when patient and caregiver decide to seek help due to psychotic symptoms. The lack of knowledge on mental health and facilities appears the main reason to explain the schizophrenic patients' HCSB. This suggests that the development of psychiatry in Cambodia will be facilitated by a better spreading of knowledge on mental health and will have to take traditional and religious medicine into account.
Abiodun, O.A. (1995) Pathways to mental health care in Nigeria . Psychiatric Services, 46, 823-826.
2.
Al-krenawi, A. , Graham, J.R. , Dean, Y.Z. & Eltaiba, N. (2004) Cross-national study of attitudes toward seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel . International Journal of Social Psychiatry, 50, 102-114.
3.
Alem, A. , Jacobsson, L. , Araya, M. , Kebede, D. & Kullgren, G. (1999) How are mental disorders seen and where is help sought in a rural Ethiopian community ? Acta Psychiatrica Scandinavica , 100, 40-47.
4.
Bou-Yong, R. , Kyoo-Seob H. , Yong-Sik K. , Yuji S. , Derson Y. , Tai- Hwang W. et al. (1995) The Health Care Seeking Behavior of Schizophrenic Patients in 6 East Asian Areas . International Journal of Social Psychiatry, 41, 190-209.
5.
Dubois, V. , Guha-sapir, D. & De Clercq, M. (1999) The importance of community mental health programmes in countries which have experienced man-made disasters. In Emergency Psychiatry in a Changing World (ed. M. De Clercq ). Oxford: Elsevier Science.
6.
Dubois, V. , Tonglet, R. , Hoyois, P. , Sunbaunat, K. , Roussaux, J.P. & Hauff, E. (2004) Household survey of psychiatric morbidity in Cambodia . International Journal of Social Psychiatry, 50, 174-185.
7.
Fosu, G.B. (1995) Women's orientation toward help-seeking for mental disorders . Social Science & Medicine, 40, 1029-1040.
8.
Gater, R. , De Almeida, E. , Sousa, B. , Barrientos, G. et al. (1991) The pathways to psychiatric care: a cross-cultural study . Psychological Medicine, 21, 761-774.
9.
Hugo, C.J. , Boschoff, D.E.L. , Traut, A. , Zungu-dirwayi, N. & Stein, D.J. (2003) Community attitudes toward and knowledge of mental illness in South Africa . Social Psychiatry & Psychiatric Epidemiology, 38, 715-719.
10.
Kiliç, C. , Rezaki, M. , Üstün, T.B. & Gater, R. (1994) Pathways to psychiatric care in Ankara . Social Psychiatry & Psychiatric Epidemiology, 29, 131-136.
11.
Kuang Yang, Y. , Hua Hsieh, H.R.N. , Chew-chung Wu, A. , Lieh Yeh, T. , Cheng Chen, C. (1999) Help-seeking behaviors in relatives of schizophrenics in Taiwan . General Hospital Psychiatry, 21, 303-309.
12.
Lin, K.M. , Inui, T.S. , Kleinman, A.M. & Womack, W.M. (1982) Sociocultural determinants of the help-seeking behavior of patients with mental illness . The Journal of Nervous and Mental Disease, 170, 78-85.
13.
Mollica, R.F. , Donelan, K. , Tor, S. et al. (1993) The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps . Journal of the American Medical Association , 270, 581-586.
14.
Sheikh, S. & Furnham, A. (2000) A cross-cultural study of mental health beliefs and attitudes towards seeking professional help . Social Psychiatry & Psychiatric Epidemiology, 35, 326-334.
15.
Silove, D. , Ekblad, S. & Mollica, R. (2000) The rights of the severely mentally ill in post-conflict societies . The Lancet, 355, 1548-1549.
16.
Srinivasan, T.N. & Thara, R. (2001) Beliefs about causation of schizophrenia: do Indian families believe in supernatural causes ? Social Psychiatry & Psychiatric Epidemiology, 36, 134-140.
17.
Van De Put, W.A.C.M. & Eisenbruch, M. (2002) The Cambodian experience . In Trauma, War, and Violence (ed. J. De Jong ). New York: Kluwer Academic / Plenum Publishers .
