title: Manifestations of affective disturbance in sub-Saharan Africa: key themes.
abstract: BACKGROUND
  Affective disorder, once seen as rare in sub-Saharan Africa, is now viewed as more common. There are however challenges in assessing rates of depression, exploring manifestations of depression, and understanding risk factors for depression, especially those related to gender.
  
  
  OBJECTIVE
  To identify key themes and new directions for research on affective disorder in sub-Saharan Africa, with particular reference to gender issues.
  
  
  METHODS
  Interpretive review of selected literature, and theoretical analysis.
  
  
  RESULTS
  There are gender differences in manifestations and rates of depression in sub-Saharan Africa, and there are forms of presentation (largely somatic, based on interpersonal relationships, or spiritual in nature) which may obscure the detection of depression. Studies are consistent however that when depressive symptoms are sought and are present, these are reasonably easy to elicit.
  
  
  CONCLUSIONS
  This was not a systematic review, and the substantial grey literature from sub-Saharan Africa was not reviewed. For many countries, there are no data available.
  
  
  CONCLUSIONS
  Affective disorder, when properly sought for through both qualitative and quantitative methods, has been found to be common in sub-Saharan Africa. There is a paucity of research on interventions with affective disorder in this region.
authors.affiliation: Medical Research Council, South Africa, South Africa. mtomlins@protem.uct.ac.za
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.forename: Leslie
authors.initials: L
authors.lastname: Swartz
authors.forename: Lou-Marie
authors.initials: LM
authors.lastname: Kruger
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D003469:Culture; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012737:Sex Factors