Title : A review of the global perspectives on traditional approaches used in the treatment of schizophrenia
Abstract:
Background: Schizophrenia remains one of the leading causes of disability worldwide, yet access to formal psychiatric care is limited in many low- and middle-income countries. Consequently, traditional healing practices continue to play an important role in the management of mental illness. While traditional medicine is widely utilized across cultures, a comprehensive understanding of the approaches used globally for schizophrenia treatment remains limited.
Objectives: This systematic review examined traditional healing approaches employed in the treatment and management of schizophrenia across different world regions and explored the evidence supporting their use.
Methods: A systematic literature search was conducted using Google Scholar, PubMed, Medline, Cochrane Library, Scopus, APA PsycINFO, and web-based sources. The Population, Intervention, Comparison, Outcomes (PICO) framework guided study selection. Studies describing traditional treatment practices from the perspectives of traditional healers, patients, or caregivers, as well as investigations of medicinal plants in animal and laboratory models, were included. Study quality and risk of bias were assessed using the Mixed Methods Appraisal Tool (MMAT) and the SYRCLE risk-of-bias tool. A total of 74 studies met the inclusion criteria.
Results: Traditional healing practices for schizophrenia were identified across Africa, Asia, Europe, the Americas, and Oceania. Herbal medicine emerged as the most commonly reported intervention worldwide. Additional approaches included faith-based healing, ancestor consultation, rituals, spiritual cleansing, acupuncture, music therapy, yoga, and psychosocial counselling. Several medicinal plants demonstrated antipsychotic, antioxidant, anti-inflammatory, and neuroprotective properties in experimental studies. Some traditional interventions were used alongside biomedical treatment and showed potential benefits, including improved symptom management and treatment adherence. However, concerning practices such as starvation, physical punishment, confinement, and other forms of coercion were also reported in certain settings. Considerable variability existed in treatment methods, preparation of remedies, dosage, treatment duration, and reported outcomes.
Conclusions: Traditional healing remains a significant component of mental healthcare globally and contributes to bridging the treatment gap for schizophrenia, particularly in resource-constrained settings. Despite its widespread use, substantial gaps remain regarding the standardization, efficacy, safety, and ethical application of traditional interventions. Future research should prioritize rigorous clinical evaluation of traditional therapies, particularly medicinal plants with demonstrated neuroprotective and antipsychotic potential, while addressing concerns related to harmful practices and patient rights.
