Psychological disturbance in African Tanzanian epileptics

138 (60%) of 230 African patients with epilepsy consecutively referred to the neurology clinic, Muhimbili Medical Centre, Dar es Salaam, had a psychological disturbance warranting intervention. 81% of them had only minor disturbance, dominated by neurotic disorders. 19% had a major disturbance dominated by a schizophrenic form of psychosis. Other major disturbances were hysterical reactions, agarophobia and severe depression. Organic brain disease was significantly associated with psychological disturbance. Over 80% of patients with major disturbance had epilepsy and brain-lesion and 77% of patients with minor disturbance had evidence of an organic brain lesion. Organic brain lesion and psychological disturbance was overwhelmingly associated with social disadvantage. Although the social attitude to epilepsy is still negative in Africa, psychological disturbance and social disadvantage in the African Tanzanian epileptic seem to be more strongly related to an organic brain lesion than to be a result of the individual reaction to social prejudices.