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Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania

Department of Psychiatry, Muhimbili University College of Health Sciences of the University of Dar-es-Salaam, Tanzania

MARTIN PRINCE, MD, MRCPsych and ANTHONY MANN, MD, FRCPsych

Section of Epidemiology, Institute of Psychiatry, London, UK

Correspondence: Mdimu C. Ngoma, 187 Parrswooodd Road, Didsbury, Manchester M20 4RR, UK

Declaration of interest None. Funding detailed in Acknowledgements.

Background Traditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services.

Aims To determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam.

Method The Clinical Interview Schedule – Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 from THCs, aged 16–65 years.

Results The prevalence of common mental disorders among THC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated with THC attendance. None of these factors explained the excess of mental disorder amongTHC attenders.

Conclusions The high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.

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