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South African Medical Journal

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Expression of schizophrenia in black Xhosa-speaking and white English-speaking South Africans

K Ensink, B A Robertson, 0 Ben-Arie, P Hodson, C Tredoux

Abstract


Objective. To inv:estigate whether schizophrenia manifests itself differently in  Xhosa-speaking South Africans, compared with English-speaking white South  Africans.
Design. A comparative study ·of the presentation of schizophrenia in two groups of patients.
Settings and subjects. A sample of 63 patients (43 Xhosaspeaking and 20 English-speaking) admitted to a large psychiatric hospital for the first time with a diagnosis of schizophrenia.
Outcome measures. The Present State Examination (PSE) was used to confirm the clinical diagnosis of schizophrenia. The Relatives' Rating of Symptoms and Social Behaviour (KAS-R) was used to obtain information on the behavioural and emotional expression of schizophrenia.
Results. A significantly higher prevalence of aggressive and disruptive behaviour was reported by relatives of Xhosaspeaking patients with schizophrenia of recent onset compared with English-speaking patients. The PSE elicited significantly more delusions of persecution, sexual and fantastic delusions, self-neglect and irritability in the Xhosaspeaking patients.
Canclusion. Significant differences in the presentation of schizophrenia, but not its core symptoms, were identified in . Xhosa-speaking blacks and English-speaking whites.



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