ANXIETY AND DEPRESSION IN AN OUTPATIENT-CLINIC IN LESOTHO, AFRICA

Objective: Past studies of psychiatric disorders in primary care in de veloping countries have utilized measures to determine conspicuous psy chiatric morbidity (CPM) rather than diagnoses. Our goal was to determ ine the prevalence of DSM-III major depression (DEP), panic disorder ( PD), and generalized anxiety disorder (GAD) in an outpatient clinic in Lesotho, Africa. Methods: As part of a larger community study, we uti lized a translated version of the N.I.M.H. Diagnostic Interview Schedu le to determine the prevalence of DEP, PD, and GAD in 126 randomly sel ected outpatients (response rate = 77%) attending a general hospital c linic. We compared these data to information about demographics and sy mptom presentation. Results: We found twenty-nine (23%) patients with DEP, thirty (24%) with PD, and thirty-six (29%) with GAD. Forty-six (3 6%) had either DEP or PD, with thirteen (45%) having concurrent illnes s. Patients with DEP and/or PD presented with a significantly higher n umber of physical symptoms, and a higher percentage of symptoms that w ere pain or autonomic nervous system related than patients with no dis order ever. Conclusion: There is significant psychiatric morbidity of common diagnoses in outpatient clinic in Lesotho, and patients present primarily with somatic symptoms, as in developed countries. There is a need for better elucidation of cross-cultural phenomenology, medical co-morbidity as a confounder, and help-seeking and treatment patterns in the developing world.