A study to assess the prevalence of possession disorder in a district of South India

ABSTRACT

Background: Possession disorders are commonly reported, especially from third world countries, like India, Far East, African and South American countries. Despite the various fast paced technological advances, possession disorder is still prevalent in various rural pockets of India. As an extension of the ongoing WHO ECA study in the department an attempt was made to look at the presentation and prevalence of this rather culturally variable and versatile disorder. Aims: To study the prevalence of ICD-10-RDC diagnosable possession disorder in the revenue district of Chittoor, India. Methods: Probability sampling design (probability proportional to Size) was employed in this study, which was based on the guidelines adopted in the ongoing WHO Longitudinal Epidemiological study on mental disorders in the department of psychiatry, SVRR Hospital, Tirupati, India. After an inquiry method utilizing the key informants in the locality the cases were identified. Then the subjects and the families were interviewed using ICD10 RDC criteria for diagnosing Possession disorder. Prevalence rates were calculated as per the data available and an attempt was made to compare the data available in the department. Results: 364 cases were diagnosed based on the methodology of inquiry of key personnel in the community. A prevalence rate of 0.048 % that is 48 per 100,000 populations is identified. But S.V.R.R.Government General Hospital Psychiatry unit being the only tertiary care facility in this area, should have treated 200 cases in a district having five million populations. During the same period census showed only four case of possession disorder out of fifty five conversion disorder patients which was a small fraction. The reason for the above finding could be that many of these cases were utilizing alternate medical or socio cultural interventions. Conclusion: Prevalence of possession disorder is still high in the rural areas and public need proper education regarding the nature and management of possession disorder. Key message Only a tip of iceberg is being treated by the psychiatrist, despite the high prevalence of possession disorder in rural India.