Psychological and social problems of epileptic children in four Southwestern Indian tribes

Abstract

According to traditional Navajo belief, sibling incest causes grand mal seizures. A 10-year study of Navajo epileptics revealed that these patients generally led troubled lives. Epileptic women were raped, gave birth to illegitimate children, and actually committed incest, whereas epileptic men tended to attempt suicide and to drink heavily. In order to test the hypothesis that negative beliefs were the major causes of these social and psychological problems, three Pueblo tribes living in the same region and served by the same health delivery system but without similar beliefs were selected for comparison. The study population consisted of all active cases of epilepsy where seizures started before age 20 and were not complicated by preexisting psychological problems or mental retardation (46 Navajos and 42 Pueblos). As predicted, Navajos were found to have social and emotional problems more often than Pueblos. Navajos exhibited problems prior to age 14 significantly more often, and significantly more Navajo females had severe problems. Navajo parents withdrew from the epileptic child; Pueblo parents treated their epileptic children as normally as possible. Special health education programs are not offered either to families or to schools, and mental health staff are not notified until emotional problems are clearly present. Half of all epileptic Pueblo children and over 70% of epileptic Navajo children do not take their medications regularly. Treatment programs appropriate to each tribe are discussed.