Background. This study aimed to investigate the onset
and predictors of common mental disorders
(CMD) in primary-care attenders in Harare, Zimbabwe.
Method. Two (T1) and 12-month (T2) follow-up of a cohort of
primary-care attenders without a
common mental disorder (N=197) as defined by the Shona Symposium
Questionnaire (SSQ),
recruited from primary health care clinics, traditional medical practitioner
clinics and general
practitioner surgeries. Outcome measure was caseness as determined by scores
on the SSQ at follow-up.
Results. Follow-up rate was 86% at 2 months and 75% at 12 months.
Onset of CMD was recorded
in 16% at T1 and T2. Higher psychological morbidity scores at recruitment,
death of a first-degree
relative and disability predicted the presence of a CMD at both follow-up
points. While female
gender and economic difficulties predicted onset only in the short-term,
belief in supernatural
causation was strongly predictive of CMD at T2. Caseness at both follow-up
points was associated
with economic problems and disability at those follow-up points.
Conclusions. Policy initiatives to reduce economic deprivation
and targeting interventions to
primary-care attenders who are subclinical cases and those who have been
bereaved or who are
disabled may reduce the onset of new cases of CMD. Closer collaboration
between biomedical and
traditional medical practitioners may provide avenues for developing methods
of intervention for
persons with supernatural illness models.