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Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors

Published online by Cambridge University Press:  03 January 2018

Vikram Patel ,
Charles Todd ,
Mark Winston ,
Fungisai Gwanzura ,
Essie Simunyu ,
Wilson Acuda  and
Anthony Mann
Vikram Patel*
Affiliation:
University of Zimbabwe Medical School, Harare, Zimbabwe
Charles Todd
Affiliation:
University of Zimbabwe Medical School, Harare, Zimbabwe
Mark Winston
Affiliation:
Royal College of Psychiatrists Research Unit, London, and St Tydfil's Hospital, Wales
Fungisai Gwanzura
Affiliation:
University of Zimbabwe Medical School, Harare, Zimbabwe
Essie Simunyu
Affiliation:
University of Zimbabwe Medical School, Harare, Zimbabwe
Wilson Acuda
Affiliation:
University of Zimbabwe Medical School, Harare, Zimbabwe
Anthony Mann
Affiliation:
Institute of Psychiatry, London
*
Dr Vikram Patel, Sangath Society, 35 Defence Colony, Alto-Porvorim, Goa 403521, India. Fax: +91 832 228566
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Abstract

Background

This study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare.

Method

This was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use.

Results

CMD was associated with female gender (.=0.04) and older age (.=0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in “thinking too much” and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests.

Conclusions

Mental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 1 , July 1997 , pp. 60 - 64
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Babor, T. F., de la Fuente, J. R., Saunders, J., et al (1992) AUDIT: The Alcohol Use Disorders Identification Test. Geneva: WHO.Google Scholar
Chavunduka, G. L. (1978) Traditional Healers and the Shona Patient. Gwelo: Mambo Press.Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders: A biosocial Model. London: Tavistock/Routledge.Google Scholar
Hall, A. & Williams, H. (1987) Hidden psychiatric morbidity: I. A study of prevalence in an out-patient population at Bindura Provincial Hospital. Central African Journal of Medicine, 33, 239–242.Google Scholar
Kleinman, A. (1980) Patients and Healers in the Context of Culture. Berkeley, CA: University of California Press.Google Scholar
Logie, D. E. & Woodroffe, J. (1993) Structural adjustment: the wrong prescription for Africa ? British Medical Journal, 307, 41–43.Google Scholar
Myambo, K. (1990) Social values and community development in rural Africa. International Journal of Psychology, 25, 767–777.Google Scholar
Ormel, J., Von Korff, M., Ustun, T., et al (1994) Common mental disorders and disability across cultures. Journal of the American Medical Association, 272, 1741–1748.CrossRefGoogle ScholarPubMed
Parry, C. (1996) A review of psychiatric epidemiology in Africa: strategies for increasing validity when using instruments transculturally. Transcultural Psychiatric Research Review. 33, 173–188.Google Scholar
Patel, V. (1995) Spiritual distress: an indigenous concept of non-psychotic mental disorder in Harare. Acta Psychiatrica Scandinavica, 92, 103–107.Google Scholar
Patel, V. (1996) Recognizing common mental disorders in primary care in African countries: should “mental” be dropped? Lancet, 347, 742–744.Google Scholar
Patel, V., Gwanzura, F., Simunyu, E., et al (1995a) The explanatory and phenomenology of common mental disorder in Harare, Zimbabwe. Psychological Medicine, 25, 1191–1199.Google Scholar
Patel, V., Musara, T., Maramba, P., et al (1995b) Concepts of mental illness and medical pluralism in Harare. Psychological Medicine, 25, 485–493.CrossRefGoogle ScholarPubMed
Patel, V., Simunyu, E. & Gwanzura, F. (1995c) Kufungisisa (thinking too much): a Shona idiom for non-psychotic mental illness. Central African Journal of Medicine, 41, 209–215.Google Scholar
Patel, V., Simunyu, E. & Gwanzura, F., et al (1997) The Shona Symptom Questionnaire: the development of an indigenous measure of non-psychotic mental disorder in Harare. Acta Psychiatrica Scandinavica, in press.Google Scholar
Reeler, A. P., Williams, H. & Todd, C. H. (1993) Psychopathology in primary care patients: a four year study in rural and urban settings in Zimbabwe. Central African Journal of Medicine, 39, 1–7.Google Scholar
Von Korff, M., Ustun, T., Ormel, J., et al (1996) Self-report disability in an international primary care study of psychological illness. Journal of Clinical Epidemiology, 49, 297–303.CrossRefGoogle Scholar
Winston, M. & Patel, V. (1995) Use of traditional and orthodox medicine in urban Zimbabwe. International Journal of Epidemiology, 24, 1006–1012.CrossRefGoogle ScholarPubMed
Winston, M. & Patel, V., Musonza, T., et al (1995) A community survey of traditional medical practitioners in Harare. Central African Journal of Medicine, 41, 278–283.Google Scholar
World Health Organization (1995) The World Health Report 1995: bridging the Gaps. Geneva: WHO.Google Scholar
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