Zar and female psychopathology in Sudan

الملخص EN

Objective: Zar is a culture-bound syndrome of possession and a folk healing practice still prevailing among women in Sudan.

The study attempts to delineate the main socio-demographic and clinical characteristics of female psychiatric patients who practice Zar.

Method: The design is that of a case-control study involving 819 women aged 40-54 years consecutively reporting for treatment at the Clinic for Nervous Disorders in Khartoum North, Sudan between 1973 and 1983.

The patients who had attended Zar were assigned to the Zar group, the others - to the control group.

Inter-group comparisons included a wide range of demographic and clinical variables, using bi-variate and multi-variate statistical methods.

The variance of therapeutic response to Zar with the clinical diagnosis was also tested.

Results: Zar attendance was reported by 287 (35%) of all patients.

Zar was most common among patients of rural origin, low education, unemployment, being never-married or divorced, having a family history of Zar, and enduring stressful life events, including marital dissatisfaction, infertility, child loss, inter-personal conflicts and chronic somatic ailments.

Both Zar attendance and favourable response to it were most typical of patients with conversion dissociative disorders, and to a lesser extent anxiety disorders.

Conclusions: Zar in Sudan is mostly prescribed for psychogenic reactions to prolonged psycho-social stressors, particularly in individuals prone to conversion/dissociative disorders.

The phenomenological parallels between personality switches during Zar trance and dissociative identity disorder need further studies.