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

  • D. R. Williams (a1), A. Herman (a2), D. J. Stein (a3), S. G. Heeringa (a4), P. B. Jackson (a5), H. Moomal (a6) and R. C. Kessler (a7)...
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.

Copyright
Corresponding author
*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)
References
Hide All
Andrew G, Peters L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 8088.
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.
Dawes A (1990). The effects of political violence on children: a consideration of South African and related studies. International Journal of Psychology 25, 1331.
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.
Dinan BA, McCall GJ, Gibson D (2004). Community violence and PTSD in selected South African townships. Journal of Interpersonal Violence 19, 727742.
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.
Flisher A, Fisher W, Subedar H (1999). Mental Health (ed. Crisp N. and Ntuli A.), pp. 345356. Health Systems Trust: Durban, South Africa.
Flisher AJ, Liang H, Laubscher R, Lombard CF (2004). Suicide trends in South Africa, 1968–90. Scandinavian Journal of Public Health 32, 411418.
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.
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.
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.
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.
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.
Hyman S, Chisholm D, Kessler RC, Patel VWH (2006). Mental Disorders: Disease Control Priorities in Developing Countries, 2nd edn. Oxford University Press: New York.
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.
Maiden RP (2005). Managing trauma in the South African mining industry. International Journal of Emergency Mental Health 7, 213217.
Mkize LP, Uys LR (2004). Pathways to mental health care in KwaZulu-Natal. Curatonis 27, 6271.
Nathan PE, Gorman JM (1998). A Guide to Treatments that Work. Oxford University Press: Oxford, UK.
Ovuga E, Boardman J, Wasserman D (2005). The prevalence of depression in two districts of Uganda. Social Psychiatry and Psychiatric Epidemiology 40, 439445.
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.
Seedat S, Stein DJ (2000). Trauma and post-traumatic stress disorder in women: a review. International Clinical Psychopharmacology 15, 2534.
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.
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.
WHO (2001). World Health Report – Mental Health: New Understanding, New Hope. World Health Organization: Geneva.
WHO (2005). Mental Health Atlas 2005. Department of Mental Health and Substance Abuse: Geneva.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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