Anxiety and depression in an outpatient clinic in Lesotho, Africa.
OBJECTIVE
Past studies of psychiatric disorders in primary care in developing countries have utilized measures to determine conspicuous psychiatric morbidity (CPM) rather than diagnoses. Our goal was to determine the prevalence of DSM-III major depression (DEP), panic disorder (PD), and generalized anxiety disorder (GAD) in an outpatient clinic in Lesotho, Africa.


METHODS
As part of a larger community study, we utilized a translated version of the N.I.M.H. Diagnostic Interview Schedule to determine the prevalence of DEP, PD, and GAD in 126 randomly selected outpatients (response rate = 77%) attending a general hospital clinic. We compared these data to information about demographics and symptom presentation.


RESULTS
We found twenty-nine (23%) patients with DEP, thirty (24%) with PD, and thirty-six (29%) with GAD. Forty-six (36%) had either DEP or PD, with thirteen (45%) having concurrent illness. Patients with DEP and/or PD presented with a significantly higher number of physical symptoms, and a higher percentage of symptoms that were pain or autonomic nervous system related than patients with no disorder ever.


CONCLUSIONS
There is significant psychiatric morbidity of common diagnoses in outpatient clinic in Lesotho, and patients present primarily with somatic symptoms, as in developed countries. There is a need for better elucidation of cross-cultural phenomenology, medical co-morbidity as a confounder, and help-seeking and treatment patterns in the developing world.
University of New Mexico School of Medicine, Albuquerque.
M
M
Hollifield
W
W
Katon
N
N
Morojele
D000349:Africa / Q000453:epidemiology; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors