Chronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based cross-sectional study

Moges Ayehu, Misganu Endriyas, Emebet Mekonnen, Mekonen Shiferaw, Tebeje Misganaw

Outbreaks of mass psychogenic illness (MPI), which are a constellation of physical signs and symptoms suggestive of organic illness with no identifiable causes. MPI has been documented in numerous cultural, ethnic, and religious groups throughout the world. The aims of this study were to document the nature and impacts of the illness, to assess interventions, and to come up with recommendations and management formulations for dealing with such kinds of outbreaks in the future. Community based cross-sectional study was conducted in June, 2015 in Derashe Woreda, Segen Area People Zone of the Southern Nations Nationalities and People's Region. Women with complaints of breast cancer but with no objective findings were the subjects of the study. Ninety-seven women were investigated using a semi-structured questionnaire for quantitative study. Two focus group discussions with seven affected and seven non-affected women and four key informant interviews were conducted using guiding questionnaires. Quantitative data was analyzed using SPSS version 20 software packages while qualitative data was analyzed manually going through thematic areas. The ages of the ninety-seven study participants ranged from 17 to 56 years, with a mean (SD) of 32.8 (8.7) years. Onset of illness was dated back to the year 2012 following the death of a 43 year old socially active woman with complications of breast cancer. Following her death many women started to report multiple vague physical complaints similar to those of the deceased woman. Even though the responses from the study participants did not specifically point to a single possible cause and means of transmission, high numbers of women believed the source of their illness could be punishment from God while some said that the cause of their suffering could be environmental pollution. Since the illness was taken to be contagious, affected women faced stigma and discrimination. Moreover, school activities and social gatherings were limited significantly. Unrealistic and exaggerated rumors and inadequate explanations about the nature and spread of the illness were the main contributing factors for the spread and prolongation of the outbreak. An organized intervention, clear and adequate explanations about the nature and transmission of the illness can contain MPI within a short period of time.