The authors’ objective was to estimate the prevalence of major depressive disorder among Rwandans 5 years after the 1994 genocidal civil war. They interviewed a community-based random sample of adults in a rural part of Rwanda using the Hopkins Symptom Checklist and a locally developed functional impairment instrument. The authors estimated current rates of major depression using an algorithm based on the DSM-IV symptom criteria (A), distress/functional impairment criteria (C), and bereavement exclusionary criteria (E). They also examined the degree to which depressive symptoms compromise social and occupational functioning. Three hundred sixty-eight adults were interviewed, of whom 15.5% met Criteria A, C, and E for current major depression. Depressive symptoms were strongly associated with functional impairment in most major roles for men and women. The authors conclude that a significant part of this population has seriously disabling depression. Work on appropriate, feasible, safe, and effective mental health interventions should be a priority for this population.
1 Center for International Emergency, Disaster and Refugee Studies, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Send reprint requests to Dr. Bolton: 159 Tilden Road, Scituate, MA 02066.
2 Research Scientist, Epidemiology of Developmental Brain Disorders Department, NYS Psychiatric Institute and G.H. Sergievsky Center, Faculty of Medicine, Columbia University, New York, New York. Director, International Program on Refugee Trauma, New York, New York.
3 World Vision International, Washington DC.
This study was supported by the Complex Emergency Response and Transition Initiative (CERTI), a program of the Africa Bureau of USAID and by World Vision International, Washington DC.