Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors

BACKGROUND: This study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare. METHOD: This was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use. RESULTS: CMD was associated with female gender (P = 0.04) and older age (P = 0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in "thinking too much" and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests. CONCLUSIONS: Mental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.