Psychopathology in primary care patients: a four year study in rural and urban settings in Zimbabwe

It has been argued that prevalence rates for psychopathology in Africa are stable over time and setting. There are, however, few longitudinal studies, and these conclusions are mainly based upon point prevalence studies. It has also been observed that African patients present with somatic symptoms, a feature argued to impede detection. Furthermore, it has been argued that such multiple somatic symptoms (three or more) are diagnostic of psychopathology. The present study examined these questions in the context of a longitudinal design. Prescriptive screenings of both rural and urban primary care patients were undertaken, and repeated the following year. The measures indicate that there is no significant difference in the rates in urban and rural settings, nor any difference in the rates over time. There were few differences between cases and non-cases in demographic characteristics, but there were differences in the clinical characteristics of the two groups. Cases tended to present with more symptoms than non-cases, thus corroborating earlier findings. In addition, the symptoms of cases tended to implicate more physiological systems than non-cases.