84

The cutaneous complications of traditional medicine in psychiatric environment are poorly documented and probably underestimated.The aim of this work is to highlight the aggressive and mutilating nature of certain traditional treatments, and to suggest the creation of a bioethics framework for the practice of these treatments. The authors report two cases (with illustration) of keloid scars in patients treated in a traditional environment for mental illness in Congo Brazzaville. In traditional environment, in the aim of chasing evil spirits supposed to be the cause of mental disorders, certain treatments can be particularly violent with complications such as skin break-ups that can leave appalling scars difficult to « bear ». These scars result in a handicap because of the aggravation of the stigma and the altered self-image. This leads to loss of self-confidence with social withdrawal and limitation of reintegration skills. This deliberate iatrogcnic complicates the management in patients who dispute the legitimacy of this type of deleterious treatment. However, this violence could be prevented by the establishment of a bioethics framework that considers all actors in the mental health care sector (traditional, religious or modern)

Les complications cutanées de la médecine traditionnelle en milieu psychiatrique sont peu documentées et probablement sous estimées. Les auteurs rapportent deux cas de cicatrices chéloïdiennes chez des patientes traitées en milieu traditionnel pour des maladies mentales au Congo Brazzaville. Le but de ce travail est de souligner le caractère agressif et mutilant de ces traitements et de suggérer la création d’un cadre bioéthique pour la pratique de ces traitements.