Kufungisisa (thinking too much): a Shona idiom for non-psychotic mental illness

Non-psychotic mental disorders are very common in primary care settings in Zimbabwe. Sociocultural factors play a profound role in the manifestation of such illness, and local idioms and concepts of illness need to be understood and related to biomedical psychiatric concepts originating in EuroAmerican cultures. One such Shona concept is kufungisisa or thinking too much. This article describes some clinical correlates and the contextual meaning of this term summarising the findings of two studies and the details of a third. Kufungisisa is used to mean both a cause and a symptom of illness. Both patients and care providers view this term as being related to mental, social and spiritual distress. The term is strongly related to biomedical constructs of non-psychotic mental illness, but is not specifically related either to depression or anxiety. We suggest that the conceptual equivalent of this term is "feeling stressed" or, in psychiatric terms as a non-specific "neurotic mental illness". Using the term kufungisisa may increase awareness and recognition of non-psychotic mental illness by the community and primary health care providers.