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An Investigation Concerning Mental Disorder in the Nyasaland Natives

With Special Reference to Primary ætiological and Other Contributory Factors

Nyasaland

ABSTRACT

1. The inmates of the Central Lunatic Asylum, Zomba, have been submitted to a detailed examination of their mental and bodily states.
   
2. An estimate of mental disorder in the general native population revealed that there is approximately one certifiable mental patient in every 15,357 people. This proportion is regarded by the writers as a gross under-estimate.
   
3. The relative proportions of sufferers from the various types of mental disorder were as follows: Psychopathic constitution and paranoia 7, epileptic psychoses 11, dementia 6, oligophrenia 2, psychoses associated with organic brain disease, general paralysis and confusional states 9, affective psychoses 18, schizophrenia 30, undetermined 1.
   
4. A higher incidence of mental disorder was noted in members of the Yao, Nyanjá and Ngoni tribes than in the members of other tribes, but such a circumstance was not unexpected, for the peoples concerned had been in much more intimate contact with European civilization than had their fellows.
   
5. 42·8% of the asylum inmates came from the three most advanced and civilized districts of the Protectorate—Zomba, Blantyre and Mlanje.
   
6. The average age on admission to the asylum of all inmates was 35·4 years.
   
7. 16·6% of the total inmates had received some education.
   
8. 57·1% of the inmates were criminal lunatics.
   
9. The inmates did not show any marked variation from the normal in weight and height. The average cranial index was 74·7.
   
10. 26·1% of the inmates had suffered from clinical malaria, 60·7% from hookworm disease,11·9% from pellagra, and 14% gave positive serum tests for hæmospirochætosis.
    
11. The previous histories and family histories of the inmates are given.
    
12. A detailed consideration of each form of mental disorder is made.
    
13. Possible ætiological factors are discussed.