DSM-III in Botswana: a field trial in a developing country

Area of Science:

• Psychiatry
• Global Mental Health
• Cross-Cultural Psychiatry

Background:

• The Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) is a widely used diagnostic system.
• Its applicability in diverse cultural and resource settings, such as developing African countries, requires investigation.
• Understanding psychiatric diagnoses in Botswana can inform global mental health practices.

Purpose of the Study:

• To evaluate the general applicability of DSM-III criteria for psychiatric diagnoses in an African outpatient setting.
• To identify specific challenges and limitations in applying DSM-III criteria in Botswana.
• To describe the clinical characteristics of psychiatric outpatients in this region.

Main Methods:

• Field study of new and repeat outpatients in Botswana.
• Application of DSM-III diagnostic criteria.
• Clinical observation and assessment of patient presentations.

Main Results:

• DSM-III criteria demonstrated general applicability for diagnosing outpatients in Botswana.
• Difficulties were noted with the utilization and application of Axis II of the DSM-III.
• Acute psychoses and culture-bound syndromes were observed to be rare in the studied population.

Conclusions:

• The DSM-III is largely applicable in diagnosing psychiatric disorders in a developing African country like Botswana.
• Adaptations or further training may be needed for consistent Axis II diagnosis.
• The low prevalence of acute psychoses and culture-bound syndromes warrants further epidemiological research.