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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

Published online by Cambridge University Press:  01 October 2007

D. R. Williams ,
A. Herman ,
D. J. Stein ,
S. G. Heeringa ,
P. B. Jackson ,
H. Moomal  and
R. C. Kessler
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: [email protected])
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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.

Keywords

Mental disordersmental health servicesSouth Africa
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 2 , February 2008 , pp. 211 - 220
Copyright
Copyright © Cambridge University Press 2007

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