The phenomenology and explanatory models of common mental disorder: a study in primary care in Harare, Zimbabwe

1995 ◽  
Vol 25 (6) ◽  
pp. 1191-1199 ◽  
Author(s):  
V. Patel ◽  
F. Gwanzura ◽  
E. Simunyu ◽  
K. Lloyd ◽  
A. Mann
Keyword(s):  
Mental Disorder ◽  
Traditional Healer ◽  
Psychiatric Symptoms ◽  
Common Mental Disorder ◽  
Somatic Symptoms ◽  
Traditional Healers ◽  
Explanatory Models ◽  
Interview Schedule ◽  
Duration Of Illness ◽  
American Concept

synopsisIn order to describe the explanatory models and the etic and emic phenomena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional healers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Schedule.Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of illness. Spiritual factors were frequently cited as causes of mental illness. Subjects who were selected by traditional healer, reported a greater duration of illness and were more likely to provide a spiritual explanation for their illness.The majority of subjects were classified as ‘cases’ by the etic criteria of the CISR. Most patients, however, showed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform to etic criteria of ‘caseness’ and they may represent a unique category of psychological distress in Zimbabwe. A wide variety of emic phenomena were elicited that have been incorporated in an indigenous measure of non-psychotic mental disorder. Kufungisisa, or thinking too much, seemed to be the Shona term closest to the Euro-American concept of neurotic illness.

scholarly journals Age and birth cohort differences in the prevalence of common mental disorder in England: National Psychiatric Morbidity Surveys 1993–2007

2011 ◽  
Vol 198 (6) ◽  
pp. 479-484 ◽  
Author(s):  
Nicola Spiers ◽  
Paul Bebbington ◽  
Sally McManus ◽  
Traolach S. Brugha ◽  
Rachel Jenkins ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Sleep Problems ◽  
Common Mental Disorder ◽  
Cohort Analysis ◽  
Psychiatric Morbidity ◽  
Interview Schedule ◽  
Cross Sectional ◽  
Cohort Differences ◽  
Secondary Outcomes

BackgroundThere are concerns that the prevalence of mental disorder is increasing.AimsTo determine whether the prevalence of common adult mental disorders has increased over time, using age–period–cohort analysis.MethodThe study consisted of a pseudocohort analysis of a sequence of three cross-sectional surveys of the English household population. The main outcome was common mental disorder, indicated by a score of 12 or above on the Revised Clinical Interview Schedule (CIS-R). Secondary outcomes were neurotic symptoms likely to require treatment, indicated by a CIS-R score of 18 or over, and individual subscale scores for fatigue, sleep problems, irritability and worry.ResultsThere were 8670 participants in the 1993 survey, 6977 in the 2000 survey and 6815 in the 2007 survey. In men a significant increase in common mental disorder occurred between the cohort born in 1943–9 and that born in 1950–6 (odds ratio 1.4, 95% CI 1.1–1.9) but prevalence in subsequent cohorts remained largely stable. More extended increases in prevalence of sleep problems and mental disorders were observed in women, but not consistently across cohorts or measures.ConclusionsWe found little evidence that the prevalence of common mental disorder is increasing.

Somatic and psychological models of common mental disorder in primary care in India

1998 ◽  
Vol 28 (1) ◽  
pp. 135-143 ◽  
Author(s):  
V. PATEL ◽  
J. PEREIRA ◽  
A. H. MANN
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mental Disorder ◽  
Care Provider ◽  
Common Mental Disorder ◽  
Somatic Symptoms ◽  
Cross Sectional Survey ◽  
Psychiatric Interview ◽  
Practical Advantage ◽  
Psychological Models

Background. Primary care attenders with a common mental disorder (CMD) frequently present with somatic symptoms. This study aimed to examine somatic and psychological models of CMD in primary care attenders in India.Methods. Cross-sectional survey of attenders at two primary care clinics. Psychiatric caseness was determined on three criteria: standardized psychiatric interview (biomedical criterion), patients' self-assessment of emotional disorder (emic criterion) and health care provider diagnosis. The GHQ-12 and the PPQ, which emphasize psychological and somatic symptoms respectively, were used as screening instruments.Results. Although somatic symptoms were the presenting complaints for 97% of subjects, 51% of subjects with a biomedically defined CMD had a psychological illness attribution. Patients with psychological attributions were more likely to be women, to have a longer duration of illness, to have higher CISR scores and were more likely to be recognized by the primary health care (PHC) physician. The GHQ-12 was superior to the PPQ in identifying cases of CMD against the biomedical criterion for both psychologizers and somatizers; both instruments performed equally well against the emic and care provider criteria.Conclusions. Psychological models may be acquired by patients as CMD becomes more chronic or severe, making them more likely to be detected by PHC physicians. Psychological symptoms are superior to somatic symptoms in detecting CMD. Shorter versions of the GHQ have comparable discriminating abilities to the 12-item version and offer the practical advantage of brevity, which may make them more acceptable to PHC physicians as a clinical screening tool.

Cultural influences on the prevalence of common mental disorder, general practitioners' assessments and help-seeking among Punjabi and English people visiting their general practitioner

2001 ◽  
Vol 31 (5) ◽  
pp. 815-825 ◽  
Author(s):  
K. BHUI ◽  
D. BHUGRA ◽  
D. GOLDBERG ◽  
G. DUNN ◽  
M. DESAI
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
General Practitioners ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Somatic Symptoms ◽  
Cultural Influences ◽  
Second Phase ◽  
Clinical Disorders

Background. Culture influences symptom presentation and help-seeking and may influence the general practitioner's assessment.Methods. We recruited Punjabi and English GP attenders to a two-phase survey in London (UK) using the Amritsar Depression Inventory and the General Health Questionnaire as screening instruments. The Clinical Interview Schedule was the criterion measure. General practitioners completed Likert assessments.Results. The second phase was completed by 209 Punjabi and 180 English subjects. The prevalence of common mental disorders was not influenced by culture. Punjabi cases more often had ‘poor concentration and memory’ and ‘depressive ideas’ but were not more likely to have somatic symptoms. General practitioners were more likely to assess Punjabis with common mental disorder as having ‘physical and somatic’ symptoms or ‘sub-clinical disorders’. Punjabi cases with depressive ideas were less likely to be detected compared with English ones. In comparison to English men, English women were under-detected by Asian general practitioners. Help-seeking English subjects were more likely to be correctly identified as cases.Conclusions. The prevalence of common mental disorders and somatic symptoms does not differ across cultures. Among English subjects, general practitioners were more likely to identify correctly pure psychiatric illness and mixed pathology; but Punjabi subjects with common mental disorders were more often assessed as having ‘sub-clinical disorders’ and ‘physical and somatic’ disorders. English women were less well detected than English men. English help-seeking cases were more likely to be detected.

scholarly journals Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania

2003 ◽  
Vol 183 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Mdimu Charua Ngoma ◽  
Martin Prince ◽  
Anthony Mann
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Health Care Services ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Traditional Healers ◽  
Primary Health

BackgroundTraditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services.AimsTo determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam.MethodThe Clinical Interview Schedule – Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 from THCs, aged 16–65 years.ResultsThe prevalence of common mental disorders among THC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated with THC attendance. None of these factors explained the excess of mental disorder among THC attenders.ConclusionsThe high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.

scholarly journals Common mental disorders and the built environment in Santiago, Chile

2007 ◽  
Vol 190 (5) ◽  
pp. 394-401 ◽  
Author(s):  
Ricardo Araya ◽  
Alan Montgomery ◽  
Graciela Rojas ◽  
Rosemarie Fritsch ◽  
Jaime Solis ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Built Environment ◽  
Psychiatric Symptoms ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Multilevel Modelling ◽  
Cross Sectional Survey ◽  
Interview Schedule ◽  
Cross Sectional

BackgroundThere is growing research interest in the influence of the built environment on mental disorders.AimsTo estimate the variation in the prevalence of common mental disorders attributable to individuals and the built environment of geographical sectors where they live.MethodA sample of 3870 adults (response rate 90%) clustered in 248 geographical sectors participated in a household cross-sectional survey in Santiago, Chile. Independently rated contextual measures of the built environment were obtained. The Clinical Interview Schedule was used to estimate the prevalence of common mental disorders.ResultsThere was a significant association between the quality of the built environment of small geographical sectors and the presence of common mental disorders among its residents. The better the quality of the built environment, the lower the scores for psychiatric symptoms; however, only a small proportion of the variation in common mental disorder existed at sector level, after adjusting for individual factors.ConclusionsFindings from our study, using a contextual assessment of the quality of the built environment and multilevel modelling in the analysis, suggest these associations may be more marked in non-Western settings with more homogeneous geographical sectors.

scholarly journals Systematic review: Symptoms of parental depression and anxiety and offspring overweight

2020 ◽  
Vol 54 ◽  
pp. 49
Author(s):  
Paula Lobo Marco ◽  
Inaê Dutra Valério ◽  
Christian Loret de Mola Zanatti ◽  
Helen Gonçalves
Keyword(s):  
Depressive Symptoms ◽  
Childhood Obesity ◽  
Mental Disorder ◽  
Common Mental Disorder ◽  
Positive Association ◽  
Depression And Anxiety ◽  
Recurrent Depression ◽  
Child Feeding ◽  
Middle Income ◽  
Symptoms Of Depression

OBJECTIVE: To evaluate the existing literature on the association between parents’ depression and anxiety and their influence on their children’s weight during childhood, identifying possible mechanisms involved in this association. METHODS: A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND (“common mental disorder” OR “mental health” OR “mental disorder” OR “depressive disorder” OR depress* OR anxiety OR “anxiety disorder”) AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR “body mass index” OR BMI). A total of 1,187 articles were found after peer selection. RESULTS: In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS: We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.

scholarly journals Receiving threatening or obscene messages from a partner and mental health, self-harm and suicidality: results from the Adult Psychiatric Morbidity Survey

2021 ◽  
Author(s):  
Sally McManus ◽  
Paul E. Bebbington ◽  
Leonie Tanczer ◽  
Sara Scott ◽  
Louise M. Howard
Keyword(s):  
Intimate Partner Violence ◽  
Mental Disorder ◽  
Partner Violence ◽  
Common Mental Disorder ◽  
Psychiatric Morbidity ◽  
Intimate Partner ◽  
Sample Survey ◽  
The Past ◽  
Self Harm ◽  
A Current

Abstract Purpose Threatening or obscene messaging is repeated, unwanted texts, emails, letters or cards experienced by the recipient as threatening or obscene, and causing fear, alarm or distress. It is rarely examined as an aspect of intimate partner violence. We describe the prevalence of exposure to threatening/obscene messaging from a current or ex-partner; characteristics of victims; and associations with other forms of violence and abuse, mental disorder, self-harm, and suicidality. Methods Cross-sectional probability-sample survey of the general population in England aged 16 + . Multivariable regression modelling tested associations between receipt of threatening/obscene messaging and current common mental disorder, past-year self-harm and suicidality. Results Threatening/obscene messages were received from a current/ex-partner by 6.6% (95%CI: 5.9–7.3) of adults who had been in a relationship; 1.7% received these in the past year. Victims were more likely to be female, under 35, single or divorced, socioeconomically disadvantaged, and to have experienced other forms of sexual and partner violence and abuse. Those who received threatening/obscene messages in the past year were more likely to experience common mental disorder (adjusted odds ratio 1.89; 1.01–3.55), self-harm (2.31; 1.00–5.33), and suicidal thoughts (2.00; 1.06–3.78). Conclusion Threatening/obscene messaging commonly occurs in the context of intimate partner violence. While often occurring alongside sexual and physical violence, messaging has an additional association with mental disorder and suicidality. Routine enquiry in service settings concerning safety, including those working with people who have escaped domestic violence, should ask about ongoing contact from previous as well as current partners. This should include asking about messaging, as well as other forms of potentially technology-enabled abuse which may become increasingly common.

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