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Lifetime prevalence of psychiatric disorders in South Africa

Published online by Cambridge University Press:  02 January 2018

Dan J. Stein ,
Soraya Seedat ,
Allen Herman ,
Hashim Moomal ,
Steven G. Heeringa ,
Ronald C. Kessler  and
David R. Williams
Dan J. Stein*
Affiliation:
University of Cape Town
Soraya Seedat
Affiliation:
University of Stellenbosch
Allen Herman
Affiliation:
Medical University of Southern Africa, Pretoria
Hashim Moomal
Affiliation:
University of the Witwatersrand, Johannesburg, South Africa
Steven G. Heeringa
Affiliation:
University of Michigan, Ann Arbor, Michigan
Ronald C. Kessler
Affiliation:
Harvard University, Cambridge, Massachusetts, USA
David R. Williams
Affiliation:
Harvard University, Cambridge, Massachusetts, USA
*
Dan J. Stein, UCT Department of Psychiatry, Groote Shuur Hospital J-2, Anzio Road, Observatory 7925, Cape Town, South Africa. Email: dan.stein@uct.ac.za
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Abstract

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Background

Data on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances.

Method

A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups.

Results

Lifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).

Conclusions

In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.

Type
Papers
Information
The British Journal of Psychiatry , Volume 192 , Issue 2 , February 2008 , pp. 112 - 117
Copyright
Copyright © Royal College of Psychiatrists, 2008 

References

1 Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, J-P, Angermeyer, 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, M-E, Borges, G, Lara, C, de Graaf, R, Ormel, 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, Brugha, TS, Aguilar-Gaxiola, S, Lee, S, Heeringa, S, Pennell, BE, Zaslavsky, AM, Chatterji, S, Ustun, TB. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004; 291: 2581–90.Google Scholar
2 Hirschowitz, R, Orkin, M. Trauma and mental health in South Africa. Soc Iridic Res 1997; 41: 169–82.Google Scholar
3 Dunkle, KL, Jewkes, RR, Brown, HC, Gray, GE, McIntryre, JA, Harlow, SD. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet 2004; 363: 1415–21.Google Scholar
4 Patel, V, Kleinman, A. Poverty and common mental disorders in developing countries. Bull World Health Organ 2003; 81: 609–15.Google Scholar
5 Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE. Lifetime prevalence and age-of-onset distributions of DSM–IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593–602.Google Scholar
6 Wittchen, H-U, Jacobi, F. Size and burden of mental disorders in Europe – a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15: 357–76.CrossRefGoogle ScholarPubMed
7 Williams, DR, Herman, A, Kessler, RC, Sonnega, J, Seedat, S, Stein, DJ, Moomal, H, Wilson, CM. The South African Stress and Health Study: rationale and design. Metab Brain Dis 2004; 19: 135–47.Google Scholar
8 Kish, L. A procedure for objective respondent selection within the household. J Am Stat Assoc 1949; 44: 380–7.Google Scholar
9 Kessler, RC, Ustun, TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93–121.CrossRefGoogle ScholarPubMed
10 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). 1994; APA.Google Scholar
11 Allison, PD. Discrete-time methods for the analysis of event histories. Social Methodol 1982; 13: 61–98.Google Scholar
12 Gureje, O, Lasebikan, VO, Kola, L, Makanjuola, VA. Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well-Being. Br J Psychiatry 2006; 188: 465–71.Google Scholar
13 Lalloo, R, Myburgh, NG, Smith, MJ, Solanki, GC. Access to health care in South Africa – the influence of race and class. S Afr Med J 2004; 94: 639–42.Google Scholar
14 WHO International Consortium in Psychiatric Epidemiology. Cross-national comparisons of the prevalences and correlates of mental disorders. Bull World Health Organ 2000; 78: 413–26.Google Scholar
15 Kessler, RC, Wittchen, H-U, Abelson, JM, McGonagle, KA, Schwarz, N, Kendler, KS, Knauper, B, Zhao, S. Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US national comorbidity survey (NCS). Int J Methods Psychiatr Res 1998; 7: 33–5.Google Scholar
16 Haro, J-M, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R., Lepine, J-P, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC. Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. Int J Methods Psychiatr Res 2006; 15: 167–80.Google Scholar
17 Horwath, E, Lish, JD, Johnson, J, Hornig, CD, Weissman, MM. Agoraphobia without panic: clinical reappraisal of an epidemiologic finding. Am J Psychiatry 1993; 150: 1496–501.Google Scholar
18 Wittchen, H-U, Zhao, S, Abelson, JM, Abelson, JL, Kessler, RC. Reliability and procedural validity of UM–CIDI DSM–III–R phobic disorders. Psychol Med 1996; 26: 1169–77.Google Scholar
19 Rumble, S, Swartz, L, Parry, C, Zwarenstein, M. Prevalence of psychiatric morbidity in the adult population of a rural South African village. Psychol Med 1996; 26: 997–1007.Google Scholar
20 Carey, PD, Stein, DJ, Zungu-Dirwayi, N, Seedat, S. Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity and service use patterns. J Nerv Ment Dis 2003; 191: 230–6.Google Scholar
21 Kirmayer, LJ. The place of culture in psychiatric nosology: taijin kyofusho and DSM–III–R. J Nerv Ment Dis 1991; 179: 19–28.Google Scholar
22 Chisholm, D, Sanderson, K, Ayuso-Mateos, JL, Saxena, S. Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions. Br J Psychiatry 2004; 184: 393–403.Google Scholar
23 Stein, DJ, Gureje, O. Depression and anxiety in the developing world: is it time to medicalise the suffering? Lancet 2004; 364: 233–4.Google Scholar
24 Seedat, S, Emsley, RA, Stein, DJ. Land of promise: challenges and opportunities for research in South Africa. Mol Psychiatry 2004; 9: 891–2.Google Scholar
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