Representations of mental health, madness, mental illness and depression in the general population of French Guiana: Similarities and differences between sociodemographic subgroups

French Guiana is a culturally diverse and socioeconomically heterogeneous territory. We aimed to describe social representations of madness, mental illness, and depression in the general population of the Cayenne area and to explore similarities and differences across sociodemographic subgroups. Cross-sectional data from the 2021 Mental Health in General Population survey were analyzed (N = 881 adults). Open-ended responses to definitions of “mad person,” “mentally ill person,” and “depressed person” were thematically coded. Perceptions of behaviors, causes, recognition, responsibility, suffering, treatability, and care pathways were assessed. Multivariate generalized estimating equations examined associations with sex, age, education, income, social situation, and country of birth. Representations distinguished depression (linked to sadness, life events, suffering) from madness and mental illness (overlapping, associated with loss of control, danger, brain dysfunction). Violence and delusions were attributed to madness/mental illness; emotional withdrawal to depression. Life events were the leading perceived cause across conditions, with biomedical views for mental illness. Professional help-seeking was widely endorsed, though hospitalization for madness notably. Stigma followed a hierarchy: highest for madness, lowest for depression. Thematic representations were homogeneous across subgroups. Subgroup differences emerged mainly in perceived dangerousness, abnormality, care preferences, and child inclusion, driven by socioeconomic factors (lower education/income associated with higher perceived danger and less formal care endorsement) rather than country of birth. Contrarily to our initial hypothesis that the diverse origins of the population would translate in heterogeneous representations in our sample, shared representations predominated, with socioeconomic inequalities shaping variations in stigma and attitudes more than cultural origins.