BACKGROUND: Little is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries. METHOD: Two and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n = 199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness. RESULTS: The persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation. CONCLUSIONS: A quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.
BACKGROUND: Little is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries. METHOD: Two and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n = 199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness. RESULTS: The persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation. CONCLUSIONS: A quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.
Authors: Victoria N Mutiso; Christine W Musyimi; Tahilia J Rebello; Isaiah Gitonga; Albert Tele; Kathleen M Pike; David M Ndetei Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2018-07-30 Impact factor: 4.328
Authors: Carolyn M Audet; Milton L Wainberg; Maria A Oquendo; Qiongru Yu; Meridith Blevins Peratikos; Cristiane S Duarte; Samuel Martinho; Ann F Green; Lazaro González-Calvo; Troy D Moon Journal: J Affect Disord Date: 2017-10-12 Impact factor: 4.839
Authors: Dixon Chibanda; Petra Mesu; Lazarus Kajawu; Frances Cowan; Ricardo Araya; Melanie A Abas Journal: BMC Public Health Date: 2011-10-26 Impact factor: 3.295