title: Understanding locally, culturally, and contextually relevant mental health problems among Rwandan children and adolescents affected by HIV/AIDS.
abstract: In assessing the mental health of HIV/AIDS-affected children and adolescents in Sub-Saharan Africa, researchers often employ mental health measures developed in other settings. However, measures derived from standard Western psychiatric criteria are frequently based on conceptual models of illness or terminology that may or may not be an appropriate for diverse populations. Understanding local perceptions of mental health problems can aid in the selection or creation of appropriate measures. This study used qualitative methodologies (Free Listing, Key Informant interviews, and Clinician Interviews) to understand local perceptions of mental health problems facing HIV/AIDS-affected youth in Rwinkwavu, Rwanda. Several syndrome terms were identified by participants: agahinda kenshi, kwiheba, guhangayika, ihahamuka, umushiha, and uburara. While these local syndromes share some similarities with Western mood, anxiety, and conduct disorders, they also contain important culture-specific features and gradations of severity. Our findings underscore the importance of understanding local manifestations of mental health syndromes when conducting mental health assessments and when planning interventions for HIV/AIDS-affected children and adolescents in diverse settings.
authors.affiliation: Department of Global Health and Population, Francois-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, MA, USA. Theresa_Betancourt@harvard.edu
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.forename: Julia E
authors.initials: JE
authors.lastname: Rubin-Smith
authors.forename: William R
authors.initials: WR
authors.lastname: Beardslee
authors.forename: Sara N
authors.initials: SN
authors.lastname: Stulac
authors.forename: Ildephonse
authors.initials: I
authors.lastname: Fayida
authors.forename: Steven
authors.initials: S
authors.lastname: Safren
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000209:etiology*; D002648:Child; D003466:Cultural Characteristics; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D036301:Qualitative Research; D012423:Rural Health; D012432:Rwanda / Q000453:epidemiology; D013315:Stress, Psychological; D055815:Young Adult