Depression and anxiety among women in an urban setting in Zimbabwe

One hundred and seventy-two women randomly selected from a Zimbabwean township were interviewed with a Shona screen for mental disorders and a semi-structured interview to assess symptoms suggestive of emotional distress, followed by the Present State Examination. Using criteria slightly stricter than threshold level 5 of the PSE-CATEGO-ID system, 30·8% of women had a depressive or anxiety disorder during the previous year. Nearly all disorders met Bedford College criteria for depression; 65% of these also had anxiety features. Only 0·6% of women had a ‘pure’ anxiety disorder not preceded by or associated with depression in the study year. Compared with London, the higher annual prevalence of disorders in Harare could mostly be accounted for by an excess of onset cases in the study year, 70% of which made a full or partial recovery within 12 months. The women's own words for these episodes included ‘thinking too much’, ‘deep sadness’ and a variety of terms describing heart discomfort, interpretation showing many of the latter to be expressions for grief, fear, or the possession of an insoluble problem, and 73% explained their symptoms as caused by a specific social stressor.