Skip to main content Accessibility help
×
Home
Hostname: page-component-7f7b94f6bd-l8tfn Total loading time: 0.247 Render date: 2022-06-29T11:20:43.351Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study

Published online by Cambridge University Press:  01 October 2007

D. R. Williams*
Affiliation:
Harvard University School of Public Health, Boston, MA, USA
A. Herman
Affiliation:
National School of Public Health, Medunsa, South Africa
D. J. Stein
Affiliation:
Department of Psychiatry and Mental Health, University of Cape Town, South Africa
S. G. Heeringa
Affiliation:
Survey Research Center, University of Michigan, Ann Arbor, MI, USA
P. B. Jackson
Affiliation:
Department of Sociology, Indiana University, Bloomington, IN, USA
H. Moomal
Affiliation:
University of Witwatersrand, Johannesburg, South Africa
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard University Medical School, Boston, MA, USA
*
*Address for correspondence: Professor D. R. Williams, Harvard School of Public Health, 677 Huntington Avenue, Room 615, Boston, MA, USA. (Email: dwilliam@hsph.harvard.edu)

Abstract

Background

South Africa's history and current social conditions suggest that mental disorders are likely to be a major contributor to disease burden, but there has been no national study using standardized assessment tools.

Method

The South African Stress and Health Study was a nationally representative in-person psychiatric epidemiological survey of 4351 adults (aged ⩾18 years) that was conducted as part of the WHO World Mental Health (WMH) Survey Initiative between January 2002 and June 2004. Twelve-month prevalence and severity of DSM-IV disorders, treatment, and sociodemographic correlates were assessed with Version 3.0 of the WHO Composite International Diagnostic Interview (CIDI 3.0).

Results

The 12-month prevalence of any DSM-IV/CIDI disorder was 16.5%, with 26.2% of respondents with disorder classified as severe cases and an additional 31.1% as moderately severe cases. The most common disorders were agoraphobia (4.8%), major depressive disorder (4.9%) and alcohol abuse or dependence (4.5%). Twenty-eight percent of adults with a severe or moderately severe disorder received treatment compared to 24.4% of mild cases. Some 13.8% of persons with no disorder received treatment. Treatment was mostly provided by the general medical sector with few people receiving treatment from mental health providers.

Conclusions

Psychiatric disorders are much higher in South Africa than in Nigeria and there is a high level of unmet need among persons with severe and moderately severe disorders.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrew, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 8088.CrossRefGoogle Scholar
Burrows, S, Laflamme, L (2005). Living circumstances of suicide mortality in a South African city: an ecological study of differences across race groups and sexes. Suicide and Life-Threatening Behavior 35, 592603.CrossRefGoogle Scholar
Dawes, A (1990). The effects of political violence on children: a consideration of South African and related studies. International Journal of Psychology 25, 1331.CrossRefGoogle Scholar
Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, JP, Angemeyer, MC, Bernert, S, de Girolamo, G, Morosini, P, Polidori, G, Kikkawa, T, Kawakami, N, Ono, Y, Takeshima, T, Uda, H, Karam, EG, Fayyad, JA, Karam, AN, Mneimneh, ZN, Medina-Mora, ME, Borges, G, Lara, C, de Graaf, R, Omel, J, Gureje, O, Shen, Y, Huang, Y, Zhang, M, Alonso, J, Haro, JM, Vilagut, G, Bromet, EJ, Gluzman, S, Webb, C, Kessler, RC, Merikangas, KR, Anthony, JC, Von Korff, MR, Wang, PS, Alonso, J, Brugha, TS, Aguilar-Gaxiola, S, Lee, S, Heeringa, S, Pennell, B, Zaslavsky, AM, Ustun, TB, Somnath, C (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association 29, 25812590.Google Scholar
Dinan, BA, McCall, GJ, Gibson, D (2004). Community violence and PTSD in selected South African townships. Journal of Interpersonal Violence 19, 727742.CrossRefGoogle ScholarPubMed
Dunkle, KL, Jewkes, RK, Brown, HC, Yoshihama, M, Gray, G, McIntyre, JA, Harlow, SD (2004). Prevalence and patterns of gender-based violence and revictimization among women attending antenatal clinics in Soweto, South Africa. American Journal of Epidemiology 160, 230239.CrossRefGoogle ScholarPubMed
Flisher, A, Fisher, W, Subedar, H (1999). Mental Health (ed. Crisp, N. and Ntuli, A.), pp. 345356. Health Systems Trust: Durban, South Africa.Google Scholar
Flisher, AJ, Liang, H, Laubscher, R, Lombard, CF (2004). Suicide trends in South Africa, 1968–90. Scandinavian Journal of Public Health 32, 411418.CrossRefGoogle Scholar
Franchi, V, Swart, TM (2003). From apartheid to affirmative action: the use of ‘racial’ markers in past, present, and future articulations of identity among South African students. International Journal of Intercultural Relations 27, 209236.CrossRefGoogle Scholar
Gureje, O, Lasebikan, VO, Kola, L, Makanjuola, VA (2006). Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well Being. British Journal of Psychiatry 188, 465471.CrossRefGoogle ScholarPubMed
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. International Journal of Methods in Psychiatric Research 15, 167180.CrossRefGoogle ScholarPubMed
Hughes, GD, Hoyo, C, Puoane, TR (2006). Fear of sexually transmitted infections among women with male migrant partners – relationship to oscillatory migration pattern and risk-avoidance behaviour. South African Medical Journal 96, 434438.Google ScholarPubMed
Hugo, CJ, Boshoff, DE, Traut, A, Zungu-Dirwayi, N, Stein, DJ (2003). Community attitudes toward and knowledge of mental illness in South Africa. Social Psychiatry and Psychiatric Epidemiology 38, 715719.CrossRefGoogle ScholarPubMed
Hyman, S, Chisholm, D, Kessler, RC, Patel, VWH (2006). Mental Disorders: Disease Control Priorities in Developing Countries, 2nd edn. Oxford University Press: New York.Google ScholarPubMed
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) survey initiative version of the WHO-CIDI. International Journal of Methods and Psychiatric Research 13, 95121.CrossRefGoogle Scholar
Maiden, RP (2005). Managing trauma in the South African mining industry. International Journal of Emergency Mental Health 7, 213217.Google ScholarPubMed
Mkize, LP, Uys, LR (2004). Pathways to mental health care in KwaZulu-Natal. Curatonis 27, 6271.Google ScholarPubMed
Nathan, PE, Gorman, JM (1998). A Guide to Treatments that Work. Oxford University Press: Oxford, UK.Google Scholar
Ovuga, E, Boardman, J, Wasserman, D (2005). The prevalence of depression in two districts of Uganda. Social Psychiatry and Psychiatric Epidemiology 40, 439445.CrossRefGoogle ScholarPubMed
Parry, CD, Pluddemann, A, Steyn, K, Bradshaw, D, Norman, R, Laubscher, R (2005). Alcohol use in South Africa: findings from the first Demographic and Health Survey (1998). Journal of Studies on Alcohol 66, 9197.CrossRefGoogle Scholar
Seedat, S, Stein, DJ (2000). Trauma and post-traumatic stress disorder in women: a review. International Clinical Psychopharmacology 15, 2534.Google ScholarPubMed
Ward, CL, Lombard, CJ, Gwebushe, N (2006). Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues. Emergency Medical Journal 23, 226231.CrossRefGoogle ScholarPubMed
Williams, DR, Herman, A, Kessler, RC, Sonnega, J, Seedat, S, Stein, D, Moomal, H, Wilson, C (2004). The South Africa Stress and Health Study: rationale and design. Metabolic Brain Disease 19, 135147.CrossRefGoogle ScholarPubMed
WHO (2001). World Health Report – Mental Health: New Understanding, New Hope. World Health Organization: Geneva.Google Scholar
WHO (2005). Mental Health Atlas 2005. Department of Mental Health and Substance Abuse: Geneva.Google Scholar
158
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *