The onset of common mental disorders in primary care attenders in Harare, Zimbabwe

作     者：Todd, C Patel, V Simunyu, E Gwanzura, F Acuda, W Winston, M Mann, A 

作者机构：Univ Zimbabwe Sch Med Dept Psychiat Harare Zimbabwe Univ Zimbabwe Sch Med Dept Community Med Harare Zimbabwe Inst Psychiat Sect Epidemiol & Gen Practice London England 

出 版 物：《PSYCHOLOGICAL MEDICINE》 (心理医学)

年 卷 期：1999年第29卷第1期

页      面：97-104页

核心收录：

学科分类：0402[教育学-心理学(可授教育学、理学学位）] 1002[医学-临床医学] 10[医学] 

主　　题：病例对照研究 队列研究 随访研究 健康状况 医学 传统 精神障碍/诊断 精神障碍/流行病学 精神障碍/心理学 试验预期值 初级卫生保健/统计学和数值数据 社会经济因素 津巴布韦/流行病学 青少年 成年人 老年人 女(雌)性 人类 男(雄)性 中年人 

摘      要：Background. This study aimed to investigate the onset and predictors of common mental disorders (CMD) in primary-care attenders in Harare, Zimbabwe. Method. Two (T1) and 12-month (T2) follow-up of a cohort of primary-care attenders without a common mental disorder (N = 197) as defined by the Shona Symposium Questionnaire (SSQ), recruited from primary health care clinics, traditional medical practitioner clinics and general practitioner surgeries. Outcome measure was caseness as determined by scores on the SSQ at followup. Results. Follow-up rate was 86 % at 2 months and 75 % at 12 months. Onset of CMD was recorded in 16 % at T1 and T2. Higher psychological morbidity scores at recruitment, death of a first-degree relative and disability predicted the presence of a CMD at both follow-up points. While female gender and economic difficulties predicted onset only in the short-term, belief in supernatural causation was strongly predictive of CMD at T2. Caseness at both follow-up points was associated with economic problems and disability at those follow-up points. Conclusions. Policy initiatives to reduce economic deprivation and targeting interventions to primary-care attenders who are subclinical cases and those who have been bereaved or who are disabled may reduce the onset of new cases of CMD. Closer collaboration between biomedical and traditional medical practitioners may provide avenues for developing methods of intervention for persons with supernatural illness models.