Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-25T20:08:03.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Anxiety and Depression in a Village in Lesotho, Africa: A Comparison with the United States

Published online by Cambridge University Press:  02 January 2018

Michael Hollifield ,
Wayne Katon ,
David Spain  and
Limakatso Pule
Michael Hollifield*
Affiliation:
University of New Mexico School of Medicine, 2400 Tucker Ave, NE, Albuquerque, NM 87131, University of Washington School of Medicine, Seattle WA 98195, USA
Wayne Katon
Affiliation:
Consult-Liaison Service, Department of Psychiatry and Behavioral Sciences, RP-10, University of Washington, Seattle, WA 98195
David Spain
Affiliation:
Department of Anthropology, Adjunct, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195
Limakatso Pule
Affiliation:
Lesotho Central Offices, Ministry of Health, Maseru, Lesotho
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Adults in a village in Lesotho, Africa, were interviewed to determine the community prevalence of major depression, panic disorder, and generalised anxiety disorder. The prevalence data were compared with data from a large epidemiological study in the United States utilising the same research instrument. There was a significantly higher prevalence of all three diagnoses in Lesotho as compared with the United States. As in the United States, women were at an increased risk for these disorders, although statistical significance was not demonstrated for depression. The majority of people (77%) who had experienced panic attacks said they had sought help for their symptoms, with the majority attending Western-trained doctors. The relationship between explanatory models and help-seeking behaviour was explored in people who had had panic attacks. Less than 40% of those with generalised anxiety disorder said they sought help.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 156 , Issue 3 , March 1990 , pp. 343 - 350
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Carothers, J. C. (1953) The African Mind in Health and Disease: A Study of Ethnopsychiatry. Monograph Series, No. 17. Geneva: WHO.Google Scholar
Cedarbaum, J. M. & Aghajanian, G. K. (1976) Noradrenergic neurons of the locus coeruleus: inhibition by epinephrine and activation by the alpha-antagonist piperoxine. Brain Research, 112, 413–419.Google Scholar
Charney, D. S., Heninger, G. R. & Breier, A. (1984) Noradrenergic function in panic anxiety. Archives of General Psychiatry, 41, 751–763.CrossRefGoogle ScholarPubMed
Derogatis, L. R., Lipman, R. S., Rickels, K., et al (1974) The Hopkins Symptom Checklist (HSCL); a self-report symptom inventory. Behavioral Science, 19, 1–15.CrossRefGoogle ScholarPubMed
Diop, B., Collignon, R., Gueye, M., et al (1982) Diagnosis and symptoms of mental disorder in a rural area of Senegal. African Journal of Medicine and Medical Sciences, 11, 95–103.Google Scholar
Egdell, H. G. (1983) Mental health care in the developing world. Brief review of first phase of WHO collaborative study on strategies for extending mental health care. Tropical Doctor, 13, 149–152.Google Scholar
Giel, R. & van Luijk, J. N. (1969) Psychiatric morbidity in a small Ethiopian town. British Journal of Psychiatry, 115, 149–162.Google Scholar
Giel, R. & le Nobel, C. P. J. (1971) Neurotic instability in a Dutch village. Acta Psychiatrica Scandinavica, 47, 462–472.CrossRefGoogle Scholar
Goadsby, P. J. (1985) Brainstem activation of the adrenal medulla in the cat. Brain Research, 327, 241–248.Google Scholar
Goldberg, D. P. (1979) Detection and assessment of emotional disorders in a primary care setting. International Journal of Mental Health, 8, 30–48.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970) Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal, ii, 439–443.Google Scholar
Goodenough, W. H. (1981) Culture, Language, and Society (2nd edn). Menlo Park, CA: The Benjamin Cummings Publishing Company, Inc.Google Scholar
Harding, T. W., de Arango, M. V., Baltazar, J., et al (1980) Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychological Medicine, 10, 231–241.CrossRefGoogle ScholarPubMed
Harding, T. W., d'Arrigo Busnello, E., Climent, C. E., et al (1983) The WHO collaborative study on strategies for extending mental health care, III: evaluative design and illustrative results. American Journal of Psychiatry, 140, 1481–1485.Google Scholar
Katon, W. (1984) Panic disorder and somatization: a review of 55 cases. American Journal of Medicine, 77, 101–106.CrossRefGoogle ScholarPubMed
Katon, W. & Kleinman, A. (1980) A biopsychological approach to surgical evaluation and outcome. Western Journal of Medicine, 133, 9–14.Google Scholar
Kessel, W. I. N. (1960) Psychiatric morbidity in a London general practice. British Journal of Preventive and Social Medicine, 14, 16–22.Google Scholar
Klein, D. F., Gittelman, R., Quitkin, F., et al (1980) Diagnosis and Drug Treatment of Psychiatric Disorders: Adults and Children (2nd edn). Baltimore: Williams and Wilkins.Google Scholar
Kucholl, V. (1985) Ethnomedical Evaluation in Lesotho 1984–1985. Lesotho: The Private Health Association of Lesotho and the Swiss Association Friends of Lesotho.Google Scholar
Laubscher, B. F. J. (1937) Sex, Custom, and Psychopathology in Bantu Tribes. London: Routledge & Kegan Paul.Google Scholar
Left, J. P. (1977) The cross-cultural study of emotions. Culture, Medicine and Psychiatry, 1, 317–350.Google Scholar
Leighton, A. M., Lambo, T. A., Hughes, C. C., et al (1963) Psychiatric Disorder Among the Yoruba. New York: Cornell University Press.Google Scholar
Levy, P. S. & Lemeshow, S. (1980) Sampling for Health Professionals. Belmont, C. A. Lifetime Learning Publishers.Google Scholar
Lilienfeld, A. M. & Lilienfeld, D. E. (1980) Foundations of Epidemiology. New York: Oxford University Press.Google Scholar
Mbanefo, S. E. (1971) The general practitioner and psychiatry. In Psychiatry and Mental Health Care in General Practice (ed. Boroffka, A.). Ibadan: University of Ibadan.Google Scholar
Murray, C. (1981) Families Divided: the Impact of Migrant Labour in Lesotho. Johannesburg: Raven Press.Google Scholar
Myers, J. K., Weissman, M. M., Tischler, G. L., et al (1984) Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 41, 959–967.CrossRefGoogle ScholarPubMed
Nandi, D. N., Ajmany, S., Ganguli, H., et al (1976) A clinical evaluation of depressives found in a rural survey in India. British Journal of Psychiatry, 128, 523–527.CrossRefGoogle Scholar
Ndetei, D. M. & Muhangi, J. (1979) The prevalence and clinical presentation of psychiatric illness in a rural setting in Kenya. British Journal of Psychiatry, 135, 269–272.Google Scholar
Nesse, R. M., Cameron, O. G., Curtis, G. C., et al (1984) Adrenergic function in patients with panic anxiety. Archives of General Psychiatry, 41, 771–776.Google Scholar
Nielson, A. C. & Williams, T. A. (1980) Depression in ambulatory medical patients. Archives of General Psychiatry, 37, 999–1004.Google Scholar
Orley, J., Litt, B. & Wing, J. K. (1979) Psychiatric disorders in two African villages. Archives of General Psychiatry, 36, 513–520.CrossRefGoogle ScholarPubMed
Redmond, D. E. Jr (1977) Alterations in the function of the nucleus locus coeruleus: a possible model for studies of anxiety. In Animal Models in Psychiatry and Neurology (eds Hanin, I. & Usdin, E.). New York: Pergamon Press.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J., et al (1981) National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry, 38, 381–389.Google Scholar
Scott Hospital Staff (1986) Scott Hospital and Health Service Area Annual Report 1966. Morija, Lesotho: LEC Print Works.Google Scholar
Seller, R. H., Blascovich, J. & Lenkei, E. (1981) Influence of stereotypes in the diagnosis of depression by family medicine residents. Journal of Family Practice, 12, 849–854.Google Scholar
Sheehan, D. V., Ballenger, J. & Jacobson, G. (1980) Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms. Archives of General Psychiatry, 37, 51–59.Google Scholar
US Department of State, Bureau of Public Affairs (1982) Background Notes: Lesotho. Washington, DC: Editorial Division.Google Scholar
US Department of State, Bureau of Public Affairs (1987) Background Notes: Lesotho. Washington, DC: Editorial Division.Google Scholar
Villacres, E. C., Hollifield, M., Katon, W., et al (1987) Sympathetic nervous system activity in panic disorder. Psychiatry Research, 21, 313–321.CrossRefGoogle ScholarPubMed
Widmer, R. B. & Cadoret, R. J. (1978) Depression in primary care: changes in pattern of patient visits and complaints during a developing depression. Journal of Family Practice, 7, 293–302.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement—PSE (9th edn) used in a population survey. Psychological and Classification of Psychiatric Symptoms. New York: Cambridge University Press.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A., et al (1977) Reliability of the PSE (9th edn) used in a population survey. Psychological Medicine, 7, 505–516.Google Scholar
Zung, W. W. K. (1971) A rating instrument for anxiety disorders. Psychosomatics, 12, 371–379.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.