Measuring the Tridosha Symptoms of Unmāda (Psychosis): A Preliminary Study

Abstract

Objective: This is a preliminary report on the development of a scale to measure the symptoms of unmāda (psychosis) attributable to tridosa (metabolic principles) by using the concepts of Ayurvedic medicine. Design: The 67-item unmāda specific symptom scale was developed on the basis of translation of Sanskrit verses describing vātaja (V), pittaja (P), and kaphaja (K) unmāda (specific symptoms of psychosis due to the imbalances of metabolic components) and by taking the opinions of experts (15 Ayurveda experts, 5 psychiatrists, and 5 psychologists). Settings: The setting for this study was Spandana Psychiatric Nursing Home Bangalore, India. Subjects: The scale was administered by an unblinded assessor to 30 consecutive patients with nonaffective psychotic disorders. Results: The unmāda specific symptom scale was associated with excellent internal consistency. The Cronbach's α for V, P, and K scales were 0.98, 0.98, and 0.97, respectively. The split-half reliability for V, P, and K scales were 0.97, 0.97, and 0.88 respectively. Scores on vātaja, pittaja, and kaphaja scales were inversely correlated, suggesting that they are mutually exclusive. The three subgroups of psychoses—paranoid schizophrenia, schizophrenia (unspecified), and unspecified nonorganic psychosis—had significantly different loadings on the three scores, having high scores on vātaja, pittaja, and kaphaja, respectively. Conclusions: The tridoshas in psychotic disorders can be measured reliably by this instrument. The scores on each of these doşas help in differentiating three types of psychosis (according to Āyurveda) that have good correspondence with prevailing classification. However, this scale must also be applied to the other 28 separate subcategories of the psychoses that are identified in the International Statistical Classifications of Diseases (version 10) and to the 10 variants of psychosis as defined by the American Psychiatric Association Diagnostic and Statistical Manual-IV-R to help better understand the true utility for use here with the various subcategories of schizophrenia.