Prevalence of Psychological Distress and Associated Factors in Urban Hospital Outpatients in South Africa (Report‪)‬

Common mental disorders such as depressive and anxiety disorders are classified in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), (1) as 'neurotic, stress-related and somatoform disorders' and 'mood disorders'. Common mental disorders (CMDs), which include depression, anxiety and somatoform disorders, make a significant contribution to the burden of disease and disability in low- and middle-income countries (LMICs). (2,3) These conditions are responsible for up to 10% of the total global disease burden. (4) Based on recent findings from World Health Organization World Mental Health surveys on the global burden of mental disorders, the inter-quartile range (IQR: 25th-75th percentiles) of lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV) disorder prevalence estimates (combining anxiety, mood, externalising and substance use disorders) was 18.1-36.1%. (5) At least one-third of all patients seen in primary care in LMICs present with CMDs. The majority of these are not recognised or are ineffectively treated. (4) Although depressive and anxiety disorders are classified as separate diagnostic categories in the ICD-10, (1) the concept of CMDs is valid for public health interventions owing to the high degree of co-morbidity between these disorders in primary care and the similarity in epidemiological profiles and treatment responsiveness. (6) Various studies have identified high prevalence rates of CMDs among primary healthcare patients in LMICs, e.g. 23% probable cases in Nicaragua, (7) 21.3% psychiatric disorders in Nigeria, (8) 23% major depression, 24% panic disorder and 29% generalised anxiety disorder in Lesotho, (9) and a prevalence of generalised anxiety and depressive disorders of 23.9% in a community-based sample in South Africa. (10)