The course of schizophrenia in Africa
Studies of the course of schizophrenia in Africa are reviewed. Two studies by the World Health Organization have reported that this disease, defined according to ICD-9-criteria, ran a more benign course in Africa as compared to Western countries. If, however, the greater prevalence of acutely developing psychosis, patient selection, the low follow-up, the high mortality rate and, possibly, the effects of neuroleptic medication are taken into consideration, the difference in course of the disease between Africa and Western countries seems to be small, if it exists at all. An overview of traditional treatments, the attitude of the family, the social circumstances of chronic patients as well as the possible role of urbanization as a precipitating and perpetuating factor of schizophrenia in Africa provide further evidence that the benign course of schizophrenia in Africa constitutes a myth.