title: Outpatient Mental Health Services in Mozambique: Use and Treatments.
abstract: To describe current outpatient mental health service use and treatments in Mozambique, the authors reviewed registry entries for 2,071 outpatient psychiatric visits at the Beira Central Hospital in Sofala Province from January 2012 to September 2014. Service use was most common for schizophrenia, followed by epilepsy, delirium, and organic behavioral disorders. Only 3% of consultations for schizophrenia were first-visit patients. Treatment seeking among women was more likely for mood and neurotic disorders and less likely for substance use disorders and epilepsy. First-generation antipsychotics, most often paired with promethazine, dominated treatment regimens. Evidence-based reforms are needed to improve identification of mood disorders and broaden care beyond severe mental disorders.
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Wagenaar
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Vasco
authors.initials: V
authors.lastname: Cumbe
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Manuela
authors.initials: M
authors.lastname: Raunig-Berhó
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Deepa
authors.initials: D
authors.lastname: Rao
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Kohrt
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Andy
authors.initials: A
authors.lastname: Stergachis
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Manuel
authors.initials: M
authors.lastname: Napúa
authors.affiliation: Dr. Wagenaar, Ms. Raunig-Berhó, Dr. Rao, Dr. Stergachis, and Dr. Sherr are with the Department of Global Health, University of Washington, Seattle (e-mail: wagenaarb@gmail.com ). Dr. Wagenaar and Dr. Sherr are also with Health Alliance International, Seattle. Dr. Rao is also with the Department of Psychiatry and Behavioral Sciences, and Dr. Stergachis is also with the School of Pharmacy, both at the University of Washington, Seattle. Dr. Cumbe is with the Department of Mental Health and Beira Central Hospital, Beira, Mozambique. Dr. Kohrt is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Dr. Napúa is with the Beira Operations Research Center, Beira, Mozambique. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Sherr
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009073:Mozambique / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012042:Registries; D012737:Sex Factors
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