OUTCOME OF COMMON MENTAL-DISORDERS IN HARARE, ZIMBABWE

Background Little is known about the outcome of common mental disorder s. (CMD) in primary care attenders in low income countries. Method Two and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n=199 ) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Q uestionnaire (SSQ) was the measure of caseness. Results The persistenc e of case level morbidity was recorded in 41% of subjects at 12 months . Of the 134 subjects interviewed at both follow-up points, 49% had re covered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, b ereavement and disability predicted a poor outcome at both times. Poor er outcome at TI only was associated with a causal model of witchcraft and an unhappy childhood. Caseness at follow-up was associated with d isability and economic deprivation. Conclusions A quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Ta rgeting risk groups for poor outcome for interventions and policy inte rventions to reduce the impact of economic deprivation may provide a w ay of tackling CMD in primary care in low income countries.