THE PHENOMENOLOGY AND EXPLANATORY MODELS OF COMMON MENTAL DISORDER - A STUDY IN PRIMARY-CARE IN HARARE, ZIMBABWE

In order to describe the explanatory models and the etic and emic phen omena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional h ealers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Sc hedule. Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of ill ness. Spiritual factors were frequently cited as causes of mental illn ess. Subjects who were selected by traditional healer, reported a grea ter duration of illness and were more likely to provide a spiritual ex planation for their illness. The majority of subjects were classified as 'cases' by the etic criteria of the CISR. Most patients, however, s howed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform to etic criteria of 'case ness' and they may represent a unique category of psychological distre ss in Zimbabwe. A wide variety of emic phenomena were elicited that ha ve been incorporated in an indigenous measure of non-psychotic mental disorder. Kufungisisa, or thinking too much, seemed to be the Shona te rm closest to the Euro-American concept of neurotic illness.