New overview of mental illness in toamasina psychiatric department in 2018

Recently, internet and social networks in Toamasina’s people life change deeply their view and their conception of mental illness that as at a long time ago, considered within our customs and traditions as pain inflected by ancestors. Our objectives are to be able to fight against the prejudices of psychiatry in Toamasina, to be able to break the barrier between several ideologists, to go further towards a psychiatry centered on more modern and adapted care. We carried out a retrospective descriptive epidemiological study of the two years (2017-2018) in the only department of psychiatry in Toamasina by using hospital data. Through an anonymous questionnaire filled by our consultants, we have been able to trace their pre - arrival careers in psychiatry. Clinically, the major psychiatric disorders recorded in Tamatave psychiatric hospital are dominated by delusional disorders, depressive mood disorders, conversive syndromes and psychiatric troubles related to alcohol and cannabis. However, in 2018, compared with in 2017, we recorded a significant increase of 5.06% in anxiety disorders, 2.02% in depressive troubles and 1.14% in cannabis use. In fact, Toamasina’s people had to deal with destabilizing events in 2018, among others, the cyclone AVA, quite powerful and destructive in January and the presidential election with political clashes at the end of the year. The interview with our patients highlights clearly this search for insurance and protection through traditional practitioners (18%) in 2018, by religion (45%), or by psychiatric care (78%). However, most of our patients choose the association Psychiatry-Religion (88%) in 2018. In a conservative country as ours, oral tradition still holds a prominent place (35%). As Malagasy have a low literacy rate, they are easily influenced by free affirmations by oral tradition. From our point of view, Malagasy people have already had their own psychotherapies long time before the introducing of Western psychiatric approach in our Island. In fact, by referring to Sigmund Freud's psychoanalysis. So, psychiatrist should have the power to identify with these therapeutics systems and even challenge them for an excellent therapy. We should enhance our efforts on the extension, the medialization of scientific knowledges, because many Malagasy audiences are still and really in ignorance.